Reconstruction Vol. 12, No. 4

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Of Zombies, AIDS, and “Africa”: Non‐Western Disease and the “Raciocultural” Imagination / Richard Brock

Abstract This essay investigates the “raciocultural”—a term designating the slippage between, and mutual construction of, “race” and “culture” within discourses of quasi‐biological determinism—as a means of exploring Western representations of non‐Western disease as “foreign” threats to Europe and North America. It suggests that the raciocultural is at once a colonial‐era construction and a reflection of contemporary trends that have seen racist discourse become increasingly displaced onto the notion of the “cultural.” Investigating a range of texts including news media, literary texts, and interactive entertainment, the essay focuses on representations of “African” space as biologically and culturally “infected” in order to examine the spatial dimensions of the raciocultural. The essay concludes by interrogating the present lack of postcolonial literary‐and cultural‐studies engagements with the institutional contexts of medicine, arguing that the readings presented here demonstrate the importance of such analysis.

Introduction: Biomedical Narratives

<1> In 2003, the BBC News website carried an article by Nick Caistor, entitled “Haiti’s Aids and Voodoo Challenge.” It suggested that internationally‐led HIV/AIDS interventions in Haiti were proving ineffective because “many Haitians […] believe that many illnesses, including Aids, are caused by magic rather than microbes” (Caistor n.p.). Contradicting well‐established anthropological evidence attesting that, from the earliest days of the AIDS pandemic in Haiti, many Haitian HIV patients were fully cognizant of the disease’s viral etiology and informed enough to follow current research into possible cures and treatments (Farmer, AIDS and Accusation), the article asserts that “[b]ecause of this magical view of life and sickness, Haitian peasants suffering from HIV or Aids are more likely to go and seek help from their local voodoo priest than from a government clinic” (Caistor n.p.). Drawing a sharp distinction between narrative modes of understanding disease and the “rational,” scientific worldview attributed to the European aid workers whose efforts it documents, the article interprets the Haitians’ “magical view” as based on primitive superstition, wholly incompatible with “rational” biomedical approaches to illness. Caistor’s article must ignore an extraordinary amount of contextual evidence in order to advance its deterministic thesis. Even if we ignore the considerable body of evidence contesting the article’s anecdotes of Haitian resistance to Western medicine [1], there are a number of entirely “rational” cause‐and‐effect explanations for any such resistance. One of these is briefly alluded to; yet, while there is the briefest of acknowledgements that “in the early 1980s Haitians were held responsible for the spread of the disease in the United States and other developed countries” (n.p.), the devastating impact on Haitians and Haitian Americans of the appalling racism and discrimination suffered as a result of this erroneous hypothesis is not offered as a possible reason for their present suspicion of the Western medical practitioners and policymakers responsible for this suffering.

<2> In doggedly pursuing its narrative of a deterministic cultural primitiveness impeding aid efforts in Haiti, Caistor’s article suppresses logical, “rational” underpinnings of Haitian patients’ health behaviours to an extraordinary degree. It employs much the same tactic in reverse when dealing with behaviours and beliefs of Westerners that—at least from the “scientific” standpoint the article strives to maintain—must be classified as irrational. Ironically, the article’s principal European interviewee and authority on “irrational” Haitian beliefs is a Belgian Christian missionary, motivated, one assumes, by a belief system no more “rational” and no less “magical” than the Haitian patients with whom he works. Yet the article’s treatment of his religion could not be more different: unlike the beliefs of the Haitians whose primitiveness and superstition he laments, the missionary’s religious beliefs are held to be sufficiently compatible with biomedical science that he is able to act as a spokesperson for a “rational,” non‐“magical” view of medicine. In its very attempts to deny a narrative dimension to Western biomedical discourse, the article thus rests, paradoxically, on its own concealed narrative—of innate Western cultural superiority to a heathen, irrational non‐West. It imagines “culture” as immutable, deterministic, and destructive—an obstacle that must be overcome before the rational work of Western medicine can begin.

<3> In positing as necessary the eventual “victory” of Western biomedical discourse over the resistance of local knowledges, the piece underlines the implicit neocolonialism underscoring the kind of aid effort it describes. Its focus on “culture” is subtler than but just as powerful as colonial‐era notions of race, reflecting a broader shift in the late‐twentieth and early‐twenty‐first centuries from “biological differences [to] sociological and cultural signifiers” (Hardt and Negri 191) as “essential” markers of difference between Western and non‐Western peoples. The article also demonstrates the unique properties of medicine and disease as “culturally” inflected phenomena. Because infection remains a biological process, culturally deterministic accounts of susceptibility to infection inevitably construct culture as quasi‐biological in its own right: as an index of infection risk that is imagined in substantially the same way as measures of genetic predisposition based on notions of an innate biological “race.”

<4> The racist assumptions underlying this article’s arbitrary assignation of notions of rationality—at odds with the ostensibly humanitarian approach it takes to its central concern with effective HIV treatment—would be disturbing enough in isolation. My contention in this essay, however, is that the series of tropes the BBC article employs in establishing a cultural hierarchy of rationality in the contexts of medicine and disease belong to a particular discursive formation—a subtle variation on colonial‐era constructions of biology, “race,” and infection that I term the “raciocultural.” This term has been used occasionally in critical theory, but almost always appears with a hyphen: the most notable usage for the present essay is arguably Tzvetan Todorov’s in On Human Diversity: Nationalism, Racism, and Exoticism in French Thought, where the hyphenated term is used more or less synonymously with “ethnicity” (91). While my use of a non‐hyphenated form here is intended to carry Todorov’s sense of the matrix of constructions of “culture” and “biological” race that constitute ethnic identity, the lack of a hyphen reflects a conception of the raciocultural as an axis along which it is possible to observe a strategic and systematic slippage, as seen in Caistor’s article, between cultural and biological discourse.

<5> The raciocultural is a construction that views culture as innate and “biological” and biology as “cultural.” I use the term here to illuminate two distinct but interrelated aspects of the interaction between culture, biology, and infection, both of which are present—the latter largely by implication—in Caistor’s BBC article. First, “culture”—specifically, aspects of cultural practice viewed as recalcitrant or “backward” in the face of the hegemony of modern biological science—is conceptualized as a quasi‐biological marker of susceptibility to infection, an immutable and (metaphorically) “genetic” predisposition to disease. Second, and as a consequence of the first construction, these supposedly recalcitrant, irrational aspects of “culture” themselves begin to be imagined as infectious, with the capacity to violate, to contaminate, and even to inscribe themselves retrovirally on the DNA of the “rational” (i.e. white, Western) body. The second trope is most often accomplished through the figure of a single, isolated Westerner—whose whiteness, whatever his or her own religious affiliations, signifies an adherence to non‐narrative, biomedical rationalism—standing bewildered in a sea of black bodies, whose adherence to an irrational, narrative “worldview” signifies at once a deterministic cultural predisposition to infection and a form of infectiousness continually menacing the “rational” white body. In the BBC article, the Belgian missionary fulfills this latter role, though as I will demonstrate presently the risk to the white body of infection/violation in raciocultural constructions of medicine and disease is often far more pronounced, to the point of generating a sustained and explicit horror.

<6> In this essay, I seek to make three main arguments about the raciocultural as a theoretical formation for understanding neo‐colonial Western constructions of non‐Western disease. First, I look to demonstrate the reach and consistency of its tropes, from journalistic texts to imaginative literary works to blockbuster video games. Second, I explore the raciocultural as a historical phenomenon of considerable longevity, arguing that, while it has become a more prevalent representational mode in the wake of broader discursive shifts from biology to “culture” as markers of difference, its particular construction of infection and infectiousness is central to older colonial discursive formations too, of which my example here is the iconic colonial conception of African “darkness” most famously demonstrated in Joseph Conrad’s Heart of Darkness. Finally, I offer some rather more speculative thoughts on the theoretical implications of the raciocultural, both for the field of postcolonial studies and for the study of contemporary public health practices.

Resident Evil 5: The Raciocultural and the Supplement

<7> Fully appreciating the reach and scope of the raciocultural in the early twenty‐first century requires a considerable lateral step, from an article carried by one of the world’s most respected news sites to a “text” bearing no obvious connection to it: a particularly controversial example of an increasingly popular entertainment genre, the zombie horror video game. The game in question is Japanese developer Capcom’s Resident Evil 5, which has proven “one of the hottest commodities in the booming video game industry, selling over five million copies worldwide since its release in 2009” (Vials 51). In his article “The Origin of the Zombie in American Radio and Film,” Chris Vials cites the film as a particularly “egregious” example of the “residual culture of imperialism” within contemporary zombie narratives, given its focus on “a white American protagonist who mows down hordes of black, zombie‐like creatures in Africa, some in urban slums, and others bearing the grass skirts, tribal masks, and spears of 1930s action‐adventure films” (Vials 51).

<8> Vials is right to identify nakedly imperialist and racist underpinnings to Resident Evil 5’s “African” milieu. Indeed, the game’s imagery has been sufficiently troubling to generate an extensive debate in the popular gaming press and among players. Posing a direct challenge to a community that on the whole tends toward the defensive and uncritical—perhaps unsurprisingly given the frequency of tabloid headlines accusing video games of direct responsibility for violent crime and social disorder—Dan Whitehead of the online publication Eurogamer argued in a preview of the game that

It’s perfectly possible to use Africa as the setting for a powerful and troubling horror story, but when you’re applying the concept of people being turned into savage monsters onto an actual ethnic group that has long been misrepresented as savage monsters, it’s hard to see how elements of race weren’t going to be a factor. […] If we’re going to accept this sort of imagery in games then questions are going be asked, these questions will have merit, and we’re going to need a more convincing answer than “lol it’s just a game.” (Whitehead n.p.)

While the questions about the game’s troubling stereotypes that sparked intense public debate are vitally important and form the foundation of my own reading, my argument that the game furnishes an example of “raciocultural” discourse entails not just an examination of its iconography, but of the flexibility of the signifiers “zombie” and “Africa”—as well as the implied signifier “Haiti” that I shall argue lurks behind all invocations of the zombie—all of which are deployed by Resident Evil 5 in order to construct an immersive experience driven by the twin “horrors” of biological and cultural “infection.”

<9> Formerly human but transformed—either by a virus or a magical ritual—into something dangerous and unreasoning, the zombie is a uniquely adaptable popular cultural figure, functioning, in many of its most recent incarnations, as a monstrous manifestation of anxieties about topics as diverse as consumer culture, global terrorism, and (crucially for our purposes) pandemic disease. Sarah Juliet Lauro and Karen Embry describe the various transformations this figure has undergone in order to embody the prevailing Western (and particularly American) anxieties of the day:

There is the Haitian zombi, a body raised from the dead to labor in the fields, but with a deep association of having played a role in the Haitian Revolution (thus, simultaneously resonant with the categories of slave and slave rebellion); and there is also the zombie, the American importation of the monster, which in its cinematic incarnation has morphed into a convenient boogeyman representing various social concerns. ...This zombie has been made to stand for capitalist drone (Dawn of the Dead) and Communist sympathizer (Invasion of the Bodysnatchers), and, increasingly, viral contamination (28 Days Later). In this passage from zombi to zombie, this figuration that was at first just a somnambulistic slave singly raised from the dead became evil, contagious, and plural. (87‐88)

In a number of important ways, the zombie’s present popular cultural configuration—the infected human body reduced to a monstrous shell that is at once malevolent and unreasoning—provides a powerfully resonant embodiment of contemporary constructions of the infected body (and the HIV‐infected body in particular) as profoundly other. One does not have to be an especially astute or subtle critic to identify the numerous allegorical links between HIV/AIDS and the contemporary “infected” zombie that have populated many a horror movie and video game in the last decade or so: the zombie plague of the now‐iconic 28 Days Later (2001) begins with a virus that jumps from primates to humans, while the opening voiceover of the 2009 horror comedy Zombieland identifies the first person to be infected by its zombification virus as “Patient Zero” [2].

<10> On one level, the “infected” zombie—more likely to show up in the urban metropolitan centres of the West than in rural areas of the Caribbean—appears to be an entirely deterritorialized species: where its “voodoo” incarnation was inextricably bound to the geographic space of Haiti and to (grotesque distortions of) Haitian “culture,” the contagious zombie has apparently transgressed its local boundaries to reflect fears of an apocalyptic global pandemic. Generally considered to have been born with George Romero’s 1968 horror film Night of the Living Dead, the infected—and infectious—zombie belongs, argues Vials, to a “separate genealogy,” whose standard plotline “involves a pandemic within the United States (or within the West)” (42). Phillip Mahoney, in an essay entitled “Mass Psychology and the Analysis of the Zombie,” makes a closely related argument. While the “voodoo” zombie “fit neatly into a predominantly racist and colonialist hierarchy that privileged the rational, white individual over the irrational and impressionable ‘tribe’” (120), Mahoney argues, “all of this begins to change” with Romero’s movie, which “changes the basic structure of the zombie‐horde, by effacing all trace of voodoo lore and installing contagion as a primary aspect of a mass zombie phenomenon” (120‐21).

<11> However, while it is true that there are often clear distinctions in mythology and physiology between constructions of the “infected” zombie and the “voodoo” zombie, my own reading of these two “breeds” of zombie through a raciocultural paradigm demonstrates that both Vials and Mahoney are mistaken about the degree of separation between them. While it may be a relatively distant relative of the voodoo zombie, the infected zombie most definitely belongs to the same family tree. And while the most visible traces of “voodoo lore” have been effaced from the infected zombie, I argue that traces of this mythology remain nevertheless, as powerful inflections that shape the type of horror represented by infection in the contemporary zombie narrative. For all the crassness of its narrative and racist iconography, Resident Evil 5 thus remains a vitally important text in the understanding of both the contemporary zombie narrative and the raciocultural representation of infection more broadly. It is worthy of particular attention firstly because of the particularly striking ways in which it exploits the iconography of AIDS as a malevolent, foreign (and specifically African) threat in its representation of the infected zombie, and secondly because of the ways it demonstrates the manner in which the text of the infected zombie—a biological (and in the particular context of the game, explicitly racial) horror—relies on a supplementary relationship (in the Derridean sense) with a second, often concealed text: the cultural horror of the Haitian zombie. Supplementing the biological with the cultural, the biomedical with the mystical, Resident Evil 5 is thus the archetypal raciocultural text of “foreign” infection menacing the white body.

<12> Exploring the nature of this supplementation entails elaborating on my claim that the notion of the infected zombie as a purely “biological” entity—stripped of the traces of the earlier “cultural” construction of the Haitian zombie—is an erroneous one. Although there may be some justification for Vials’s suggestion that the earliest incarnations of the infected zombie, as manifested in the films of George Romero, are genealogically distinct from the Haitian “voodoo” zombie, the emergence of AIDS—along with the attendant proliferation of narratives constructing black bodies as originary and dangerous sources of HIV infection—has seen these lineages become increasingly intertwined. It is not merely that, as Vials correctly asserts, “suggestion [the principal source of violation associated with the “voodoo” zombie] and contagion are similar in that they are both something like ‘anti‐properties,’ which connote an innate or constitutive ‘openness’ to external influence” (117). Rather, as Barbara Browning points out in her compelling book Infectious Rhythm: Metaphors of Contagion and the Spread of African Culture, imaginative affinities between fears of AIDS as an emergent foreign disease and a parallel set of fears, associated with the unfettered black body and carried by the zombie as popular horror figure, became literalized in US biomedical narratives in the 1980s:

The Western press has made the connection [between zombies and AIDS] in a causal, not figural sense. Believe it or not, the Journal of the American Medical Association published an article by Dr. William R. Greenfield entitled: “Night of the Living Dead II: Slow Virus Encephalopathies and AIDS: Do Necromantic Zombiists Transmit HTLV III/LAV During Voodooistic Rituals?” (27)

<13> The reasons for the particular position of Haitian magical practices within the Western popular imagination are complex and numerous, but the location of Haiti certainly plays a substantial role. Often prefaced with such descriptions as “the poorest country in the hemisphere,” Western invocations of Haiti are almost invariably inflected with an implicit sense of the incongruous. Haiti is both Africa out of place and North America out of time, a space whose uncanny associations of unbelonging were intensified by the appropriation of American revolutionary rhetoric by the Haitians who staged the world’s only successful slave rebellion. As Browning notes, “Haiti was the only black‐ruled republic in the world, and it represented to the United States a terrifying vision of its own ostensible political philosophy” (90). In the American imaginary, Haiti remains a threatening liminal zone through which “Africa” is allowed more or less free passage into the US, without having to traverse the reassuringly vast space of the Atlantic Ocean. The fear of this uninterrupted passage of “Africanness” into North America has led to the liminal zone of Haiti coming to represent all that is most savage, monstrous, and darkly mysterious about Africa. Haiti thus possesses the curious imaginative properties of a limen run amok: at once a gateway to and intensified microcosm of Africa. Significantly, the conflation of Haiti with “Africa” allows for a rhetorical continuity between long‐debunked theories that AIDS originated in Haiti (or, indeed, that zombies constituted a substantial infection vector!) and the current prevailing narrative of its African origin.

<14> Since Browning’s analysis of imaginative parallels between HIV/AIDS and zombies appeared in the mid‐1990s, the infected zombie has experienced a dramatic surge in popularity across a variety of genres (including the aforementioned films), no doubt due in part to its encapsulation of fears of emerging and pandemic disease [3], but also shaped by significant improvements in interactive technology, leading to the birth of the immersive “survival‐horror” video game. Prior to the release of installment number five, the Resident Evil franchise—comprising a succession of blockbuster video games and successful move spin‐offs—had, in combination with more recent series such as Left 4 Dead, exerted a considerable influence on the currency of the infected zombie, and on its nature as a creature of science fiction, apparently unconnected to the cultural creation of the “voodoo” zombie. (It is worth noting, however, that in Japan, where the series is developed and produced, it is marketed under a different English‐language title, Biohazard. Together, the different names under which the game is marketed point to two conflictual aspects of the biomedical narratives attached to HIV/AIDS in the West, one referring to a biological threat, the other to a malevolent and devious agency. With respect to Resident Evil 5 in particular, neither title is able fully to capture the game’s construction of infection by itself; each is required to supplement the other.)

<15> Early installments in the Resident Evil series focus on an underground research facility hidden beneath an innocent‐looking mansion, where hideous, zombified experiments with a DNA‐altering virus known as the T‐virus form the player’s main enemies. Responsible for these experiments is a shadowy pharmaceutical manufacturer and symbol of corporate corruption known as the Umbrella Corporation. If the narrative of the series is mostly an assemblage of science fiction clichés, the games have been especially valued among players and critics for their immersive sense of tension and menace, requiring players to survive zombie attacks with a very limited supply of weapons, ammunition, and healing items. The immersion factor has of course increased with improvements in graphical and processing technology, and Resident Evil 5 is the first in the series to be released with high‐definition visuals. The representational ethics of immersion are placed into sharp relief in Resident Evil 5, which places the player in the role of returning character Chris Redfield, who is dropped in a dilapidated “African” village (no nation is specified, though—in keeping with representations of Africa as politically volatile—the opening voiceover does tell us that the region is “unstable”) at the start of the game. Chris, a white American soldier, is pointedly differentiated from the variety of menacing African non‐player characters he encounters, whether they are infected with a zombification virus or not. The player partakes of Chris’s racial characteristics, inhabiting the role of the white Westerner whose bodily integrity is placed under continual threat by “contagious” African bodies and territory. When playing on a PlayStation 3 system, the player has the option of using the PlayStation Move controller, a motion‐sensing peripheral that allows the player’s bodily motions to be directly mapped onto the character; if this option is chosen, the player’s “embodiment” of Chris’s role approaches the literal.

<16> Overall, the game proceeds in a manner similar to other iterations in the series: the player fights or flees from hordes of zombies while various cutscenes construct a backstory to what by now, six games into the series, is a fairly complex and extensive mythology. There are some important differences, however: Resident Evil 5 is the first game in the series to take place outside the “West” (volumes 0 to 3 took place in the US; number 4 was set in Spain) and, in a move that strikingly echoes biomedical narratives of African AIDS, this installment takes the form of an origin narrative. Through the course of the game, the player will learn that the “progenitor virus” from which the T‐virus derives originated in Africa. In another pointed echo of current issues around HIV/AIDS, the game’s overarching narrative is dominated by the unethical practices of a pharmaceutical corporation (Umbrella) in the Third World, cultivating an anti‐colonial sentiment for the most part—none of which precludes the reiteration of imperialist tropes in the construction of “Africa” or Africans. Fully appreciating the multiple discourses of race, “culture,” and contagion in which the game participates, however, necessitates a focus on its memorable prologue, leading up to the encounter (some ten minutes or so into the game) with its first zombie.

<17> Having taken control of Chris following the opening cutscenes, the player is free to explore the game’s first environment at leisure, before advancing to a checkpoint that will trigger the opening mission. One of the first sights the player encounters is a group of Africans using sticks to beat something—a dog, perhaps, or is it someone?—in a bag. As the player approaches them, they stop and stare. One of them beats a stick into his hand. For as long as the player remains, these figures will continue to stare menacingly, without offering any option for interaction. In another setting, this lack of interactivity might be regarded as an oversight; here, however, it is clearly a deliberate design choice. The African figures are intended to covey a silent menace, a barely suppressed—and racially inherent—savagery.

<18> After triggering the next stage of the game, the player spends the next few minutes encountering a number of objects apparently related to dark magic practices, as the focus of the game’s construction of Africa’s innate metaphysical “infectedness” is displaced from the racial to the “cultural.” It is here that the game signals a radical departure from the series’ previous entries, which operated within a more‐or‐less exclusively science‐fiction framework. While Resident Evil 4 featured superstitious European peasants, that game made clear that, within its own universe, their beliefs were erroneous responses to scientific phenomena; by contrast, the dark magic artifacts of Resident Evil 5’s opening lend an ambiguous causality to the zombification we are about to encounter. The cultural “infectedness” of its African space allows the game to reinscribe onto the contemporary infected zombie a second set of fears, relating to magic, “voodoo” and the black body. The text of the “voodoo” zombie thus fulfills the ambiguous role that Derrida assigns to the supplement—“neither an outside nor the complement of an inside” (43)—demonstrating in microcosm the mutually supplemental relationship between race and culture along what I have been calling the axis of the raciocultural where representations of disease and otherness are concerned. In Resident Evil 5, “cultural” innateness becomes a supplement to the text of biological, racial innateness in that it serves at once as an external complement to that text and as an integral part of it, without which it is impossible to read the full range of its implications. The supplementation of the “biological” text of the infected zombie with the older, “cultural” text of the “voodoo” zombie in these moments of the game marks not only the convergence of two types of horror—the black body animated by dark magic and the malevolent, monstrous source of infection—but reproduces the narratives of raciocultural causality that inform by the BBC article with which I began and the scholarly texts explored by Browning. In Resident Evil 5, the infected zombie does not merely reflect a related set of fears to the “voodoo” zombie; rather, the latter begets the former insofar as a set of “cultural” stereotypes associated with the “voodoo” zombie are positioned as conditions for predisposition to infection: as secondary causes of the biological infection itself and hence as direct threats to the bodily integrity of the white player character.

<19> The “cultural” supplementation of the narrative of biologically and racially innate predisposition to infection—refracted through the monstrousness of the racial and cultural zombie—is underlined in the build‐up to the player’s encounter with this figure as the player walks through a door and encounters a shelf full of (human? primate?) skulls, quickly followed by an animal carcass on a table. Pressing a button to interact with this item prompts Chris to speculate that it is for “some ceremony.” A letter on a table in the same room carries a cryptic message about a “sacred death,” further reinforcing the suggestion of “primitive” spiritual practices overlaying the primary science fiction narrative. A short while later, we encounter the game’s first zombie, after he is force‐fed a mutated virus. After everything we have already seen, it is scarcely a surprise when the victim’s eyes start to roll, and he raves, foams at the mouth, and attacks the player. He is, after all, “infected” by much more than simply a virus. He is “infected” by the primitiveness that the game has been careful to place in a metaphysically causal role; he is infected by his own blackness, his Africanness, his cultural and racial predisposition towards violence and disease.

Heart of Darkness: Territoriality and the Raciocultural

<20> In Resident Evil 5, race, culture, and contagion exist in a set of mutually deterministic relationships. In the logic of its game world, infected bodies are “African” because African bodies are “infected,” and vice versa. And the significations of both “African” and “infected” are highly unstable because each is both a biological and a metaphysical construction, mediated through a notion of “culture” that encompasses aspects of both. Given its particular resonance in contexts where HIV/AIDS is directly or metaphorically addressed, it would be easy to assume that the metaphorical scheme via which the game constructs the horrific threat of infection to the white body is a fairly recent phenomenon, emerging along with contemporary fears of pandemic disease in an increasingly borderless, globalized world. However, as I move into the second part of my argument, I want to demonstrate that the raciocultural is a construction with a far longer historical reach into the colonial imagination. Through a consideration of one of postcolonial studies’ most frequently discussed and debated texts, Joseph Conrad’s Heart of Darkness, I seek to demonstrate that raciocultural tropes have become so prevalent in the construction of emerging diseases in neocolonial contexts because these same tropes have long been central to the imagining of colonized space.

<21> Key to understanding the role of the raciocultural in the colonial imaginary is appreciating the way in which both geographical territory and bodies are imagined as bounded, yet permeable and vulnerable spaces. In the figures of Chris Redfield in Resident Evil 5 and the Belgian missionary in the Caistor article, we have seen how, when juxtaposed with an uninfected white body, the otherness of the non‐white body (which is always already “genetically” infected by “culture”) becomes an index not just of the risk of its own infection, but of its infectiousness. However, in order to map this process we must focus not only on raciocultural slippage, but also how the spatial coordinates of this slippage are mediated through the concept of territoriality. As defined by cultural geographer Peter J. Taylor, territoriality refers to “a form of behaviour that uses a bounded space, a territory, as the instrument for securing a particular outcome. By controlling access to a territory through boundary restrictions, the content of a territory can be manipulated and its character designed” (151).

<22> Colonialism represents at once an exemplary and peculiarly paradoxical exercise of territoriality, since the acquisition and maintenance of an empire served as a means of accruing the necessary power to maintain the security and sovereignty of the archetypal bounded space: the European nation state. Yet the acquisition of territory continually disclosed the permeability of territory and territorial boundaries, underlining the transitoriness of ownership over space. In his article “Security, Disease, Commerce: Ideologies of Postcolonial Global Health,” Nicholas B. King explains the significance of this paradox in the context of historical and contemporary territorial approaches to disease:

Colonial‐era public health was … marked by an obsession with exporting the European ideology of territoriality, even if in practice this ideal was seldom achieved. Western medical theories identified particular places (under miasmatic theory) or populations (under germ theory) as sources or reservoirs of infection. Unhealthy (non‐Western) places or populations posed a threat to healthy (Western) individuals when the borders between them were transgressed, either by colonials in foreign lands, or by immigrants contaminating home countries. (772)

The conception of contagion in spatial terms coexists with an uneasy relationship to territoriality that imagines the transgression of borders reciprocally. Anxieties surrounding this reciprocity, argues King, have only intensified in contemporary Western responses to perceived non‐Western immunological threat, which continue to imagine defences against disease “at home” in terms of national security, while also imagining globalization, and its attendant deterritorialization, as the best means by which to disseminate Western healthcare epistemologies abroad.

<23> This is only part of the story, however: as we have already begun to see through the monstrous figure of the zombie, this reciprocity is imagined not only in geographic but also in bodily terms. The colonizing body’s transgression of bounded territory gives rise to fears of permeation of the body as bounded territory. Both in the historical contexts of imperialism and the contemporary context of US neo‐colonialism/globalization, the interests of the dominant group require that bodily and geographic boundaries remain at once absolutely open and absolutely closed. Complete permeability of these borders was required for the physical conquest of territory and the sexual conquest of the native body in the era of high imperialism, and is necessary in the contemporary global marketplace for the dissemination of Western technologies (including medicines delivered directly into the body), products, and discourses. Simultaneously, it is imperative that the Western nation‐state and the body of the colonizer maintain impenetrable borders, and thus immunity to (literal or metaphorical) contagion.

<24> However, through the very fact of its colonization, colonized space discloses the vulnerability of national boundaries, and thus becomes a menacing source of anxieties about reverse colonization. The primary site of this anxiety is the colonizing body—a fragment of the colonizing power’s “territory” adrift in a threatening “other” space—and the anxiety of bodily permeation thus figures the colonized space (and the bodies that inhabit it) as infectious. In its imperviousness to the territoriality of bounded spaces, disease (real or imagined) discloses the inherent vulnerability of all humans to infection. Refracted through the lens of colonial penetration anxiety, however, this disclosure is read not as a universal truth about biology but as a specific menace to the (geographic and bodily) space of the colonizer, a reading on which the supposedly “rational” Western biomedical approach to non‐Western medicine is predicated. This primal fear is hence to be found not only in the obviously irrational terror of “infected” non‐Western bodies, but also in the seemingly more prosaic public health practices of naming and legislating against “risk groups.”

<25> The territorial underpinnings of the raciocultural are demonstrated in a particularly striking manner in Conrad’s Heart of Darkness, a text subject to seemingly perennial debate among postcolonial scholars. An extensive body of criticism exists exploring the thematic tensions between Conrad’s anti‐imperialist sentiment and his fixation on racial otherness [4], and as early as 1989, the novel’s tropes were already recognized as having a pervasive influence on Western depictions—even sympathetic ones—of “African” AIDS. In his article “Missionary Positions: AIDS, ‘Africa’, and Race,” Simon Watney argued that, thanks to Conrad, “we already always know these scenes … it is as if HIV were a disease of ‘Africanness’, the viral embodiment of a long legacy of colonial imagery which naturalises the devastating economic and social effects of European colonialism in the likeness of starvation—bodies reduced to [in Conrad’s terms] ‘bundles of acute angles’” (48). Watney’s observations about this discursive lineage are detailed and convincing, but, as I shall argue in the final section of this essay is typical of the (limited) extant approaches to colonial representation and disease, the scope of his article (as reflected by its title) is restricted to the discursive construction of race through the disease narrative. I want to propose here that shifting the terms of our inquiry just a little, from the racial to what I have been calling the raciocultural, reveals the relationship between Conrad’s novel and medical discourse to be far closer than even Watney suggests. By focusing on the novella’s structural level, it is possible to discern a raciocultural slippage between physical and psychological contagion functioning as a major driving force behind key plot events, manifested principally in an acute colonial penetration anxiety.

<26> This anxiety is evident from the opening pages of the novel, whose setting on the River Thames allows for the early establishment of an uncanny doubling between the English river and the “darkness” of the River Congo, through Marlow’s opening words “And this also … has been one of the dark places of the earth” (5). Even before he commences his narrative, Marlow is anxious that its “moral”—that the penetration of the “darkness” of colonized territory by the “civilized” entails the constant risk of being penetrated by this “darkness,” of a return to “the night of first ages” (42)—not go unheeded by his listeners. Prefacing his African narrative with a speculation about the scene that might have greeted the first Romans to arrive on British shores— a list of horrors that includes “sandbanks, marshes, forests, savages,” and concludes with “cold, fog, tempests, disease, exile, and death,—death skulking in the air, in the water, in the bush” (6)—Marlow underlines his “moral” by highlighting an equivalency that is imaginatively central to the novella: uncivilized space is equated with disease and death, the threat of regression to the “night of first ages” with the threat of contagion.

<27> It is fitting, therefore, that Marlow’s last port of call before his departure for the Congo is a visit to the doctor:

The old doctor felt my pulse, evidently thinking of something else the while. “Good, good for there,” he mumbled, and then with a certain eagerness asked me whether I would let him measure my head. Rather surprised, I said Yes, when he produced a thing like calipers and got the dimensions back and front every way, taking notes carefully. … “I always ask leave, in the interests of science, to measure the crania of those going out there.” “And when they come back too?” I asked. “Oh, I never see them,” he remarked; “and, moreover, the changes take place inside, you know.” (13)

Inscribed into this episode are two irreconcilable (pseudo‐) medical narratives, each inflected with elisions between culture and race. The first, alluded to by the doctor’s measuring of Marlow’s head with calipers, references phrenology, a pseudoscientific mapping of the brain largely discredited by Conrad’s time, which purported to be able to discern certain features of an individual’s character through measurements of the skull. Commonly invoked in discourses of racial determinism, phrenology regarded race and nature not only as intrinsically linked, but as immutable and essential. Yet, even as it alludes to this immutability, the passage points toward a separate, incompatible narrative of race, darkly hinting that racial characteristics might be not only mutable but contagious: that certain environments might render one susceptible to “infection” by racial otherness. Curiously, however, the doctor’s last sentence suggests the beginnings of a slippage between race and “culture”: the suggestion that changes to one’s essential racial make‐up might take place undetectably, “on the inside,” hints at something essential and deterministic within an individual that controls her/his capacity for rational, “civilized” thought, but, in its phrenological unmeasurability, goes beyond race.

<28> Unnerved but not dissuaded by this foreboding medical consultation, Marlow continues his journey, and arrives in the Congo Free State. Here, as Marlow encounters a workforce of slaves building a railway, the tone for the rest of the novel is set. Despite his allegiance to the “idea” of colonialism in principle, Marlow finds its brutal realities abhorrent, and is shocked by the colonial administration’s treatment of the slaves. Nevertheless, these slaves and their suffering add to the atmosphere of impending menace, as moral culpability for their plight is rhetorically transferred from their captors to an ineffable evil—or “darkness”—intrinsic to the continent of Africa itself. Like all Conradian Africans, the slaves themselves are inscrutable and dead‐eyed, their menace intensified as “they passed me within six inches, without a glance, with that complete, deathlike indifference of unhappy savages” (18). And, unsurprisingly, the space they inhabit begins to be imagined as infectious: “They were dying slowly—it was very clear. They were not enemies, they were not criminals, they were nothing earthly now,—nothing but black shadows of disease and starvation, lying confusedly in the greenish gloom” (19).

<29> From this point on, the inherent menace of African “darkness” and the threat of contagion are metaphorically and structurally inseparable. Marlow journeys towards the inner station on the Congo, where he hopes to find Kurtz, a brilliant, idealistic ivory trader and imperialist philosopher. When he arrives at the central station, however, he finds that the steamer of which he was to take command has been sunk, forcing him to delay for several months. Marlow finds the manager of the central station an unremarkable man, except for an unusually strong constitution, but does begin to suspect that the manager is responsible for the sinking of his vessel. When Marlow finally reaches Kurtz, he is already sick and close to death, “infected” not only by physical disease, but by a madness that Marlow attributes to his prolonged exposure to a continent whose insanity is both endemic and contagious. Resistance to disease thus determines a European’s ability to succeed in Africa: Kurtz is an exemplary European, a high‐minded man with (according to Marlow) fine ideals, but, isolated at the inner station, he has repeatedly been afflicted with physical and metaphysical sickness, and has “taken a high seat amongst the devils of the land” (59). The manager of the central station, by contrast, has an innate resistance to disease, which is what, more than any good qualities of character, allows him to prosper and be promoted beyond his capacity. By sinking Marlow’s vessel, he forces the continued isolation of Kurtz, his rival for promotion, in the hope (well‐founded, as it turns out) that the “climate may do away with this difficulty” (37).

<30> At the level of plot, then, disease plays a determining role in the events of Heart of Darkness. What is even more revealing, however, is the way in which the fear of infection—becoming ever more acute as Marlow penetrates into the interior and fears of his own permeability intensify proportionately—shapes Marlow’s journey on a structural level. In his seminal essay on Heart of Darkness, the Nigerian novelist Chinua Achebe makes the observation that “Conrad’s famed evocation of the African atmosphere … amounts to no more than a steady, ponderous, fake‐ritualistic repetition of two sentences, one about silence and the other about frenzy” (784). Whether or not we agree with Achebe’s assessment of Conrad’s style as little more than a smokescreen for a compulsive and offensive fixation on the racial other, the point that the novel is characterized by a tension between silence and frenzy is an astute one. Consider the following passage, describing the beginning of Marlow’s overland trek to the central station:

Paths, paths, everywhere; a stamped‐in network of paths spreading over empty land, through long grass, through burnt grass, through tickets, down and up chilly ravines, up and down stony hills ablaze with heat; and a solitude, a solitude, nobody, not a hut. The population had cleared out a long time ago. Well, if a lot of mysterious niggers armed with all kinds of fearful weapons suddenly took to travelling on the road between Deal and Gravesend, catching the yokels left and right to carry heavy loads for them, I fancy every farm and cottage thereabouts would get empty very soon. (Conrad 23)

Conrad is an astute enough stylist that, in context, the repetition here, first of the word “paths,” and subsequently of a succession of directional clauses, contributes to an overall sense of chaos and disorder intensified by the lack of main verbs; the proliferation of paths seems to add to the pervasive air of sinister, savage “frenzy.” When the passage is taken out of context, however, we can quickly appreciate the level of dissonance between tone and content. The abundance of paths, which stylistically and tonally is employed to reflect the disorder, untamed savagery and inhospitability of what Conrad persistently calls a “wilderness,” in fact indicates precisely the opposite: that the “wilderness” has been tamed, and clear paths marked through it that make Marlow’s passage easier. The ease of his passage, in fact, is what unnerves Marlow. He invents imaginary threats—“mysterious niggers armed with all kinds of fearful weapons”—to explain why the road ahead of him is presently unobstructed, but encounters none. Instead, later within the same paragraph, the narrative begins to dwell on the threat of contagion—of the terror of the indiscernible, raciocultural transformations that “take place inside.” First, one of Marlow’s European companions “got fever, and had to be carried in a hammock slung on a pole” (23). The man is heavy, however, and the Africans who are tasked with carrying him begin to protest. Marlow is forced to communicate with them by making “a speech in English with gestures, not one of which was lost to the sixty pairs of eyes before me” (24). Worrying that such interactions are beginning to effect changes to his fundamental character, Marlow recalls his encounter with the doctor immediately before his departure: “I remembered the old doctor,—‘It would be interesting for science to watch the mental changes of individuals, on the spot.’ I felt I was becoming scientifically interesting” (24).

<31> In this passage, Marlow is unsettled not by any actual dangers he faces, but by the relative ease of his journey: his “adversaries” are imagined, his encounters with the natives far less dangerous than he fears they will be. The boundaries surrounding the “dark” territory of the Congolese interior prove to be psychological rather than physical, and readily permeable. The intense anxiety about infection and illness that follows Marlow’s construction of imaginary dangers is a direct consequence of the transgression of these boundaries, which are remapped onto the bodily space of the transgressing European. Though Marlow’s boat does eventually—and briefly—come under attack, for the most part it is the ease, rather than difficulty, of his penetration into the interior that governs his responses to its psychological and geographic territory, governed always by a fear of reverse bodily colonization directly proportional to his progress. Thus, even when Marlow does depart on the journey where he comes under overt attack, from the central station towards Kurtz’s inner station, the fear of the ambush that actually materializes is a distant second to Marlow’s suspicion of his own steamer’s crew of Africans, who Marlow is by now convinced are “cannibals.” Again, however, Marlow’s primary fears fail to materialize: he reflects, puzzled, that the cannibals have had ample opportunity to “tuck in” to the Europeans, whom they greatly outnumber, but have not done so: “Why in the name of all the gnawing details they didn’t go for us—they were thirty to five—and have a good tuck in for once, amazes me now when I think of it” (49). This reflection is again immediately followed by an episode of bodily anxiety, as later in the same paragraph, Conrad has Marlow imagine that he is coming down with an infection: “One can’t live with one’s finger everlastingly on one’s pulse. I had often ‘a little fever,’ or a little touch of other things—the playful paw‐strokes of the wilderness, the preliminary trifling before the more serious onslaught which came in due course” (50).

<32> Marlow, then, is unsettled by his journey not because it is fraught with dangers, but because it is too easy: there are few “savages” and no “cannibals” to impede him: the most substantial obstacle to his progress is the sinking of his steamer by the manager of the central station. The permeability of African “wilderness” induces a proportionate fear of the permeability of his own bodily territory, which will be manifested in a final and terrible “onslaught” when his journey reaches its conclusion. As it turns out, the nightmare of complete territorial invasion by African contagion is experienced not by Marlow but by Kurtz, whose penetration of the Congo’s territorial “darkness” has, by the time Marlow reaches him, been too deep and too permanent to offer any hope of salvation. The single sentence with which Marlow sums up the consumption of the ailing Kurtz by African darkness is perhaps the most remarkable in the whole book: the “wilderness,” Marlow asserts, “had taken him, loved him, embraced him, got into his veins, consumed his flesh, and sealed his soul to its own by the inconceivable ceremonies of some devilish initiation” (58). What is so remarkable about this sentence is its encapsulation of so many stereotypes about the racial other—the “African” other, in particular—that have become entrenched in Western narratives about the dark continent and “foreign” disease. The causes attributed to Kurtz’s sickness are numerous and conflictual, but in Heart of Darkness’s metaphorical economy of spatial and raciocultural infection, they make perfect sense. At one and the same time, Kurtz is seduced and/or raped by an infected lover who is both lascivious and sadistic (acquiring a kind of metaphysical syphilitic madness in the process), and made the subject of a mysterious dark magic ritual. He is infected by contagions both physical and metaphysical, and by the primal savagery of “Africa” itself.

<33> The preponderance of raciocultural tropes in Conrad’s Heart of Darkness demonstrates a clear continuity between colonial‐era uses of (metaphorical) infection in conceptualizing the otherness of colonized spaces, races, and cultures and present‐day Western responses to (literal) infection in the non‐West that rely on these conceptions of otherness. It is striking, in the context of the foregoing discussion of Resident Evil 5, to note the way in which Conrad’s racioculturally inflected echoes of the uncannily human and the monstrous persist in contemporary figure of the “infected” zombie, especially when the traces of “African” cultural anxieties underpinning this construction are as clearly manifested as they are in Capcom’s controversial game. There are notable parallels between the aspects of this zombie that are most horrific—its uncanny resemblance to the uninfected human, its unreasoning malevolence, and the constant threat of infection it carries—and some of the most memorable passages from Heart of Darkness, in which depictions of the natives play on a near‐identical set of fears. There is the steamer’s “cannibal” helmsman, for instance, who when confronted with adversity sheds the thin veneer of “civilization” bestowed on him by colonialism, regressing into an almost rabid state of savagery as “his eyes rolled, he kept on lifting and setting down his feet gently, his mouth foamed a little” (Conrad 54). Then there is arguably the novella’s most (in)famous evocation of African savagery—the transformation of the “accustomed” sight of the “conquered monster” into “a thing monstrous and free,” the terror of which is located not in its inhumanity but in the uncanniness of “the thought of their humanity—like yours—the thought of your remote kinship with this wild and passionate uproar” (43). The structural arc of Heart of Darkness’s various fears of infection and penetration—beginning with a skull measurement in a European doctor’s office and ending with the discovery of a metaphysically violated, racially and culturally “infected” Kurtz as the embodiment of Marlow’s darkest fears—demonstrates the imaginative potency of the raciocultural as an axis of visceral bodily fear. This is a fear that—far from being consigned to a distant colonial past—continues to proliferate in a representational economy that trades on the notion of emerging diseases as dark, foreign threats posed to white bodies by non‐white ones.

A Sunday at the Pool in Kigali: Humanitarianism, Decolonized Space, and Cultural Determinism

<34> Without clear evidence of such continuities, it would be easy to dispute the relevance of Conrad’s novella to contemporary medical discourse, and to read it as simply a product of its time: after all, while Conrad is deeply critical of colonial practices, Heart of Darkness remains entrenched in a notion of European cultural and racial superiority to Africans. Yet a century on, many of its assumptions about racial otherness and colonial space remain uncomfortably ingrained in culturally inflected accounts of Third World (and especially “African”) disease. If some of these—like Resident Evil 5—trade on racist prejudice in the service of popular entertainment, others—like the BBC article with which I opened—proceed on broadly humanitarian grounds, seemingly oblivious or even ideologically opposed to the colonial tropes they reproduce. This is a deeply unsettling feature of contemporary treatments of non‐Western infection—almost more so when these treatments aim to be socially and culturally responsible. In this section I want to continue to point to the puzzling persistence of raciocultural tropes in contemporary infection‐texts that position themselves explicitly in opposition to racial and cultural stereotyping, while arguing that the explanation for this persistence may lie in the adoption of deterministic discourse even by many of the most sensitive and self‐reflexive approaches to cultural competency in the area of healthcare provision.

<35> “Cultural competency” covers a broad range of approaches to culturally situated healthcare and medical practice, ranging from those that perpetuate the notion of “culture” as an obstacle to effective healthcare that underpins Caistor’s BBC article to those that insist on a relativistic approach to situated knowledges. The former set of approaches has drawn increasing criticism in recent years as critics like Delese Wear have noted that “efforts in cultural competency may actually reinforce the ‘Otherness’ and marginalization of disenfranchised groups and individuals” (Wear et al 2). Aware of this risk, and in large part guided by the motivation to guard against it, are such practical texts as Mohan J. Dutta’s Communicating Health: A Culture‐Centered Approach, a guide for professionals in the fields of health communication and education to integrating cultural difference into their practice. A necessary corrective to the unidirectional conception of health education espoused by the “obstacle” model of cultural competency, the culture‐centered approach advocated by Dutta draws on a variety of postcolonial frameworks, especially subaltern studies, to highlight the perspectival nature of all narratives of health and disease, including the biomedical model. As articulated by Dutta, the emancipatory potential of such an approach is considerable:

[T]he culture‐centered approach offers an avenue for opening up the dominant framework of health communication to communities and contexts that have so far been ignored, rendered silent and been treated simply as subjects of health communication interventions. By examining how we communicate in our traditional health interventions and the linkages between these interventions and the dominant value systems, the approach offers us opportunities to question the inherent biases in our modes of thinking about health and of going about promoting it in communities. (14‐15)

Dutta’s approach revolves around a model in which healthcare choices are determined by interactions between structure (healthcare institutions), culture (the networks through which individuals interpret healthcare messages), and agency (the capacity of an individual to act on the healthcare information s/he receives). His culture‐centric model thus foregrounds the ways in which agency is granted or curtailed according to a matrix of socio‐economic factors, including not only “cultural” norms but also practical access to resources and facilities.

<36> As a practical counter to the paternalism of the Western medical establishment, the benefits of Dutta’s work are incalculable. However, approaching it from the anti‐essentialist standpoint of postcolonial studies from which Dutta himself draws extensively also reveals its potential pitfalls, most notably in the ways in which it shares some of its assumptions with hegemonic discourses of cultural determinism. As we have already begun to see, Western accounts of medicine and disease in the non‐West routinely fall prey to what Anne Phillips identifies as a “tendency to attribute all aspects of behaviour to culture when dealing with people from a minority group, while regarding the behaviour of others as reflecting their personal choice” (29). The primacy afforded to “culture” within the postcolonial theoretical frameworks on which he draws means that Dutta, on occasion, falls prey to the same kind of selective attribution of cultural determinism. This is illustrated most clearly when he argues that

[an] important element to note is the defining role of culture in creating a lens through which health practices are envisioned and practiced. Although the individual might operate as the vehicle through which a certain behavior is enacted, cultural practices much stronger than his/her personal evaluations of that behavior might hold the key to understanding it. These cultural practices might be located in the social cement as opposed to being located within the individual. (24)

This opinion is offered in the context of a critique of prevailing (Western) models of health behaviour that “place emphasis on cognitive evaluations as precursors to the adoption of the healthy behavior,” which Dutta argues discount “alternative discursive spaces where a systematic evaluation of the target behavior does not precede health practices” (23). As ever, Dutta’s attention to “alternative discursive spaces” is laudable (note, however, that the use of “alternative” immediately ascribes primacy and “conventional” status to Western modes of understanding), but the argument here relies on a deterministic model of culture that threatens to smuggle back in the assumptions of raciocultural innateness that characterize the very worst Western constructions of non‐Western health practices: Westerners act on the basis of an evaluation of a proposed behaviour; non‐Westerners have their behaviour determined in advance by the “social cement” of their culture(s).

<37> Within even the most self‐aware culture‐centric approaches to healthcare, then, there are traces of the deterministic logic that has driven Western constructions of non‐Western infection and metaphorical uses of infection in imagining colonized space. The result is a set of tensions and contradictions at the heart of contemporary attempts to understand and represent the relationship between culture and disease in the non‐West. In this regard it is instructive to examine A Sunday at the Pool in Kigali, Quebecois novelist Gil Courtemanche’s brilliant but deceptively Conradian novel about AIDS and the Rwandan genocide. Lauded for its compassionate depiction of the catastrophic effects of the AIDS pandemic and the legacy of colonialism on one particular African community, A Sunday at the Pool in Kigali is equally notable for its figurative use of infection—deployed in a strikingly similar manner to the infection metaphors in Heart of Darkness—to diagnose the “cultural” malaise of a failed post‐independence African state.

<38> At first glance, Courtemanche’s fact‐based novel could not be a more different proposition to Conrad’s novella. Avowedly humanitarian in its focus, it depicts Rwanda on the eve of the 1994 genocide, and gives a human face to some of the many victims of both the genocide and the AIDS epidemic that by 1994 was already sweeping the country. The novel principally follows Bernard Valcourt, a Quebecois TV journalist, and his Rwandan lover Gentille, a Tutsi of Hutu lineage. Valcourt journeys to Rwanda initially as part of a project funded by the Canadian government, which aims to set up a state TV station to educate the local population about good health practices, particularly with regard to AIDS prevention. When the TV station project eventually collapses, Valcourt decides instead that he will make a documentary film, documenting the lives of those afflicted with HIV and AIDS. There are many things to admire about A Sunday at the Pool in Kigali, among which is its advocacy of a culture‐sensitive approach to understanding the AIDS pandemic. Courtemanche is scathing about the paternalism of Western public health interventions in Africa, satirizing some of their underlying neo‐colonial impulses, as when Valcourt is recruited to the Rwandan TV station project by the “director of democratic development for the Canadian International Development Agency,” who demonstrates both idealism and ethnocentrism in his assertion that “we begin with hygienic necessities, with programs on prevention, on dietary matters, then the information gets into circulation, and information is the beginning of democracy and tolerance” (Courtemanche 17‐18).

<39> If Courtemanche is scathing about this kind of self‐serving interventionism, he is kinder to his worldly protagonist (who is contemptuously dismissive of the director’s sales pitch). But on occasions Valcourt too is guilty of paternalistic attitudes to the Rwandans he befriends, especially the AIDS patients he begins filming for his documentary. One afternoon, Valcourt, along with Gentille, is visiting such a friend, Cyprien, who is not only HIV‐positive himself, but also has two children who are carrying the virus. Valcourt is perturbed by Gentille’s easy laughter in the face of such devastation, as she plays with Cyprien’s children. To his question “how can you laugh so easily?” she is emphatic in her response: “Because I’m alive and the children are alive and right now things are good for us. D’you want more reasons?” (81‐82). Gentille chastises Valcourt for a binary view of health and disease, which places patients infected with HIV—even those who are asymptomatic—among the sick and dying, and expects their behaviour, and the behaviour of all those who interact with them, to reflect this classification at all times. Suggesting that Valcourt’s cultural perspective on the issue differs fundamentally from his own, Cyprien follows up Gentille’s rebuke with one of his own, telling Valcourt that “you see dead bodies, skeletons, and on top of that you want us to talk like we’re dying. I’ll start doing that a few seconds before I die, but until then I’m going to live and fuck and have a good time” (82).

<40> According to Cyprien, Valcourt’s allegiance to a particular predetermined, “scientific” narrative—of an inevitable progression from infection to illness to death—blinds him to all others, located in the contingencies of life and human interaction. There is no space in Valcourt’s worldview, for example, for an HIV‐infected child to be happy, especially in a Third World location defined by poverty and hardship: where his host sees life, Valcourt sees only death in waiting. Such encounters enable Courtemanche’s novel to explore the disjunct between the AIDS epidemic as experienced by the subjects of Valcourt’s documentary film—even those who are his friends—and Valcourt himself, whose subject position inevitably remains detached, secure, and incalculably privileged by comparison. While this disjunct allows the book to advocate for a culture‐sensitive approach to health and disease, however, it is also central to the parts of the book that are most problematic in their construction—in the Conradian tradition—of raciocultural and territorial “infection.” The novel opens by articulating Western privilege and its precariousness in spatial terms, by focusing on Kigali’s Hôtel des Mille‐Collines and its titular pool:

All around the pool and hotel in lascivious disorder lies the part of the city that matters, that makes the decisions, that steals, kills, and lives very nicely, thank you. The French Cultural Centre, the UNICEF offices, the Ministry of Information, the embassies, the president’s palace (recognizable by the tanks on guard), the crafts shops popular with departing visitors where one can unload surplus black market currency, the radio station, the archbishop’s palace. Encircling this artificial paradise are the obligatory symbols of decolonization: Constitution Square, Development Avenue, Boulevard of the Republic, Justice Avenue, and an ugly, modern cathedral. Farther down, almost in the underbelly of the city, stands the red brick mass of the Church of the Holy Family, disgorging the poor in their Sunday best into crooked mud lanes bordered by houses made of the same clay. Small red houses—just far enough away from the swimming pool not to offend the nostrils of the important—filled with shouting , happy children, with men and women dying of AIDS and malaria, thousands of small households that know nothing of the pool around which others plan their lives and, more importantly, their predictable deaths. (1‐2)

<41> Where Conrad constitutes this spatial threat principally through the process and fear of penetration, Courtemanche constructs it instead by focusing on a static locus of white privilege, a bounded enclave whose incongruous location—surrounded on all sides by “darkness”—implicitly carries the constant threat of boundary violation. The primary function of this passage is to demarcate the hotel as an enclave for privileged elites, and to emphasize the gulf between the luxurious lives of officials and expatriates and the citizens of Kigali whom their actions most affect. However, while it accomplishes this goal effectively, it also assembles a spatial allegory of colonialism and decolonization in microcosm, with white expats at the center, a mass of impoverished Africans on the periphery, and the figures of post‐independence government somewhere in between. The Mille‐Collines exemplifies Taylor’s definition of territoriality, capable of functioning as a power centre, home to important governmental transactions both legitimate and illicit, precisely because of its bounded nature. However, overlaid onto the narrative map Courtemanche creates is a second spatial allegory, uniting geographic and bodily space. The space of the poor is also a reeking, festering space of sickness and “predictable deaths” (from which the “nostrils” of the elite require insulation), a physically and metaphysically “infected” space where AIDS is not only a material consequence of poverty but a metaphorical reflection of a sociological malaise. The institutions of post‐independence government surround the neo‐colonial body politic of the hotel and pool like a kind of cell membrane, whose corruption renders it vulnerable to infection from without. And, like Conrad before him, Courtemanche constructs this vulnerability in a dualistic fashion, presenting the breaching of the boundaries that surround the hotel as a direct moral consequence of neo‐colonial hubris, while also suggesting that disease and death are innate spatial qualities of the surrounding African “darkness.”

<42> Courtemanche also follows Conrad in his fascination with the in‐between figure of the “Westernized” African. For both authors, this trope functions primarily to introduce an element of the uncanny into an innate African propensity for unpredictable violence. For Courtemanche, it also plays an important role in the mutual metaphorization of the Rwandan genocide and the AIDS pandemic, both of which become reflective of a more generalized African “sickness.” Surprisingly, given his evident sympathy for the plight of ordinary Rwandans, as well as an in‐depth knowledge of the colonial origins of the ethnic tensions that precipitated the genocide [5], Courtemanche’s most profound contempt is often reserved for Africans who belong to elites of one kind or another and who mimic “Western” mannerisms and behaviours. The mimicry on display here is not the variety described by Homi Bhabha, where the uncanny reproduction of the colonizer in the body of the colonized produces space for subtle, appropriative resistance; rather, it is the hollow, pitiable state to be found in V.S. Naipaul’s darkest works [6]. Courtemanche’s Naipaulean contempt for colonial mimicry is exhibited in the novel’s opening pages, where “the obligatory symbols of decolonization” are made to seem ridiculous, and the biggest crime of the “ugly, modern cathedral” seems to be its lack of resemblance to “real” (which is to say, old) cathedrals. Post‐independence Kigali is dismissed at a stroke as a squalid, inauthentic upstart attempting to mimic the grandeur of old Europe, but failing even to approximate the simulacrum of Vieux Montréal.

<43> This distaste for African approximations of Europeanness surfaces regularly, but perhaps nowhere so pointedly as in the scene where a Rwandan recently returned from Paris is employed rather less as a character than as a complement to setting, establishing the Hôtel des Mille‐Collines as a space of both fakery and excess:

At the end of the terrace, walking slowly and grandly, appears a Rwandan just back from Paris. You can tell, because his sporty outfit is so new its yellows and greens are blinding, even for sunglass‐protected eyes. There’s sniggering at a table of expatriates. Admiration at several tables of locals. The Rwandan just back from Paris is afloat on a magic carpet. From the handle of his crocodile attaché case dangle First Class and Hermès labels. In his pocket, along with other prestige labels, he probably has an import licence for some product of secondary necessity, which he will sell at a premium price. (5)

The primary mode here is one of ridicule: the reader is guided to identify with the sniggering expatriates and not only to scorn the man in the “sporty outfit” but also to view the naïveté of the admiring locals with a mixture of amusement and pity. This would be problematic in itself, but the motif of “colonials” mimicking Western privilege not rightly theirs becomes a central means by which the novel mutually metaphorizes the impending genocide and the AIDS pandemic, each serving as a moral reflection of the other, and as an indictment of racioculturally innate African primitiveness “mutated” by Westernization. This complex set of metaphorical equivalencies is crystallized moments after the scene above. The Rwandan just back from Paris falsely claims to be a nephew of the president, prompting a reflection from Valcourt on the president’s actual nephews:

No, he’s not one of the president’s nephews. Valcourt knows them all. The one who plays the political science student in Quebec but in Rwanda organizes death squads that go after Tutsis at night in Remero, Gikondo and Nyamirambo. And the one who controls the sale of condoms donated by international aid agencies, and another who has AIDS and thinks the way to get rid of his poison is by fucking young virgins[.] (6)

The reflection here on three of the president’s nephews metaphorically unites both the impending genocide and the AIDS crisis with the figure of the corrupt African employing Western privilege as a veneer for his innate savagery. Genocide and AIDS are constructed as the inevitable consequences of a partially Westernized Africa that fuses the worst of “civilization”—greed, corruption, nepotism—with the worst of African “darkness”: a “natural” inclination towards both violence (the secret death squads) and primitive superstition (the belief that “fucking young virgins” will cure HIV infection). The innateness of these characteristics is underscored by their appearance in the same family: the implication that they are genetically encoded enables them to stand metonymically for a wider “African” population whose DNA is inscribed (whether from birth or by a metaphorical retroviral infection) with both violence and disease.

<44> At odds with both its commendable humanitarian compassion for the particular AIDS victims it focuses on and its advocacy of culture‐sensitive modes for comprehending health and disease, Courtemanche’s novel relies structurally on a conception of “Africa,” and Africans, as spatially and culturally infected. The structure of the book’s constructions of disease and territoriality is central to the tension that mounts steadily towards its climax, as what I have characterized as the “cell membrane” of the Mille‐Collines is breached. No longer insulated from the “predictable deaths” of those who live outside its walls, the hotel has become porous, as “Valcourt and Gentille learned in bits and pieces that their world was collapsing around them. There were now several hundred people camping around the pool, in the parking lot and in the corridors of the hotel. The hotel’s water supply and telephone lines had been cut” (217).

<45> This spatial violation is reproduced on a bodily level shortly afterwards, as Gentille, having been separated from Valcourt, is brutally attacked and raped by a Hutu militia. When she is eventually reunited with Valcourt, Gentille cannot countenance the idea of resuming their relationship, asking him “don’t you smell the sickness?” before asserting that she “probably has AIDS,” and that she is “not human any more … a body that’s decomposing, an ugly thing I don’t want you to see” (257). Through the figure of her rape, the body of Gentille—which, through her relationship with Valcourt, has become both African and non‐African—is violently rendered permeable, infected by both (culturally innate) African violence and (biologically innate) African sickness. While neither her AIDS‐like symptoms—she reports that “my mouth is full of sores that keep me from eating sometimes” (257)—nor her death six months after this event from “a lightning‐fast attack of pneumonia” (258) conclusively proves that she has contracted HIV, it is clear that this African “disease,” and its fellow continental “infection” of genocidal violence, are the principal metaphorical causes of her death.

<46> Among five review excerpts proudly displayed on the cover of my copy of A Sunday at the Pool in Kigali, two are especially resonant with regard to the book’s metaphorical construction of Africa. Undoubtedly Yann Martel’s assertion that the novel is “a Heart of Darkness for today” (n.p.) is intended as an unequivocal compliment, but as I have tried to show here, its structural reliance on Conradian motifs is what frequently undermines the book’s humanitarian concerns, constructing “Africa” as a place where disease and violence are racioculturally and spatially innate. A second excerpt, perhaps even more resonant than Martel’s review, is from Canada’s National Post newspaper, and asserts that “above all, it is [Courtemanche’s] insistence on love, and the right to live one’s life passionately and well, even in the face of AIDS and the genocide, this double helix of devastating African tragedies, that make this book great” (n.p.). The “double helix” metaphor used here of course explicitly references the double‐stranded molecules of DNA, not only suggesting that AIDS and genocide are intertwined humanitarian disasters for the people of Rwanda, but also underlining the potent appeal of Courtemanche’s construction of “Africa” as retrovirally infected, its biology metaphysically inscribed with disease and violence.

Conclusion: Implications for Current Theories

<47> Though the body of texts discussed above ranges widely in terms of genre, audience, purpose, and even ideology, its diversity in these respects serves only to underline the remarkable consistency of vision with which “Africanness”—conceived as a biological, a cultural, and a spatial phenomenon—functions synonymously with infectedness (or susceptibility to infection) within Western biomedical narratives. Potent allegories for Western constructions of non‐Western disease, they allegorize the interlinked discourses of race, culture, and territory by proposing them as mystical, secondary causes for Third World disease, supplementing the ostensibly “scientific” view of microbial etiologies with the colonial notions of metaphysical “darkness” from which monstrous projections like the zombie derive their currency of primal fear. Crucially, they invite their audiences to partake of the bodily and territorial anxieties of Westerners perpetually menaced by these dark, mysterious forces.

<48> Methodologically, I have tried to demonstrate the importance of mapping continuities between “cultural” representations of infection (i.e. literature, music, visual art, film, interactive entertainment) and treatments of “culture”—understood as a set of values, customs, and norms—by social workers, anthropologists and frontline healthcare providers. This methodology is broadly in line with approaches taken by postcolonial literary and cultural theorists to a variety of other socio‐political contexts. Following the lead of foundational figures like Edward Said and Gayatri Spivak, a major strand of postcolonial theory follows a broadly Foucauldian paradigm in which the reading of representational texts offers insight into imaginative and discursive constructions that inform “material” practices at personal, institutional, military, and governmental levels. However, as medical historian Warwick Anderson observes, while “medicine has become a common reference point for many subaltern histories, as well as figuring in much historical anthropology,” it continues to be “largely ignored in contemporary [literary and cultural] postcolonial theories” (647).

<49> The present lack of engagement with medical discourses within postcolonial literary and cultural studies is puzzling for several reasons. Postcolonial theory as a field derives from poststructuralist and historiographic models that have been applied extensively to medical discourses: Michel Foucault’s Birth of the Clinic is as foundational a text to medical humanities as his Archaeology of Knowledge and “The Order of Discourse” are to postcolonial criticism, while much of David Arnold’s work on epidemiology in colonial India was undertaken as part of the Subaltern Studies collective, whose approaches to historiography have profoundly influenced prominent postcolonial theorists such as Gayatri Chakravorty Spivak. What is perhaps even more surprising, however, is that, as the predominantly discursive and imaginative focus of postcolonial theory has drawn increasing opposition from critics who insist on more “materialist” approaches to the political realities of colonial and neocolonial contexts [7], (neo)colonial medicine has not yet emerged as a ground for mediation between the two sides. There are, after all, few sites more intimate, more concrete, more “material” than the colonized body at the mercy of imperial practitioners; few sites more powerfully indicative of the constitutive power of discourse than the construction of this body as othered space. There are, in short, few historical and contemporary sites where there is more at stake in deconstructing “the unquestioned pouvoir‐savoir of imperialist axiomatics” (Spivak 122).

<50> None of this is to suggest that a field of discursive analysis that might be termed “postcolonial medical humanities” does not already exist; it is, however, to suggest that it is a curiously fragmented field, its constitutive parts constrained by both disciplinary and geographic boundaries in a manner atypical of the broader interdisciplinary field of postcolonial studies. Some of the most important substantial contributions to the understanding of colonial and neocolonial constructions of infection and disease have come in the shape of social and anthropological histories of medicine that engage with colonial and postcolonial issues (some, but not all, written under the rubric of “tropical medicine” studies). Notable examinations of how colonial medical practices in particular times and places have functioned—and continue to function—to mediate race consciousness have tended to focus on one particular locale, including India (Arnold), Canada (Kelm, Lux), Australia (Anderson, Cultivation), and the Philippines (Anderson, Colonial Pathologies). To some extent, continuities between these histories and contemporary discourses surrounding medicine and globalization (especially with respect to HIV/AIDS) are drawn by works such as Dennis Altman’s Global Sex and Cindy Patton’s Globalizing AIDS. Yet, uncharacteristically of postcolonial studies more broadly, a critical consensus affirming the intrinsic value of comparative approaches to regionally situated studies, and of an interdisciplinary focus on the politics of cultural representation, seems lacking. [8]

<51> Such a comparative approach is adopted, on the sparsely populated literary‐critical front, by Alan Bewell’s Romanticism and Colonial Disease, which performs a similar function with respect to medical humanities to that of Edward Said’s Culture and Imperialism with respect to literary theory, exploring how constructions of foreign disease helped to shape an emerging imperial consciousness within eighteenth‐and nineteenth‐century Europe. However, where the “contrapuntal” reading methodologies suggested by Said’s text have become foundational to postcolonial studies—and to readings of contemporary as well as historical literature and culture—no analogues to Bewell’s book with a contemporary literature focus exist. Sander Gilman’s pioneering work on the intersections between medical discourse and constructions of race addresses both contemporary and historical representational forms and is another indispensable resource for investigations of (post)colonial medicine, and the range of his investigations is testament to the value of a broad comparative perspective. Yet the very historical and geographic range of Gilman’s investigations means that his work requires additional mediation for use in a specifically colonial/postcolonial context in order to establish the sociocultural configurations of these grounds for comparison among the many others identified by Gilman.

<52> In developing the notion of the raciocultural, therefore, I have been rather more indebted to critics whose primary identifications are with feminist theory—but who nevertheless focus in whole or in part on (neo)colonial contexts—than to self‐identified postcolonialists. In Infectious Rhythm, Barbara Browning explicitly links imaginative representations (in music, literature, and film) to public health discourses and practices in outlining the extent to which metaphorical uses of contagion in imagining “culture” dovetail with constructions of “culture” in the context of public health policy and disease treatment. In her book How to Have Theory in an Epidemic: Cultural Chronicles of AIDS, meanwhile, Paula A. Treichler observes that “understanding the AIDS epidemic as a medical phenomenon involves understanding it as a cultural phenomenon,” while cautioning that “excessively positivist or commonsensical notions of culture may limit our ability to recognize that AIDS is also a complex and contradictory construction of culture” (99). Combining the power of these two insights, Priscilla Wald’s book Contagious: Cultures, Carriers, and the Outbreak Narrative focuses on the capacity of narrative accounts of emerging diseases (including Ebola and HIV) as cultural phenomena to “more than reflect and convey the lessons of science” and to “suppl[y] some of the most common points of reference, which influenc[e] social transformation and disease emergence in their own right” (31).

<53> While Wald does briefly cite an article and book by Warwick Anderson, there is in general remarkably little crossover, much less conversation, between these feminist cultural analyses of colonial medical discourse and the explicitly “postcolonial” critics mentioned above, a fact that underlines the fragmentary and disparate nature of the discursive field of postcolonial medical humanities at present. These feminist critics do, however, offer instructive suggestions as to where postcolonial literary and cultural theory can usefully contribute to this field and potentially mediate between some of its more disparate elements. If the situated treatments of colonial medicine referenced above focus primarily on the construction of “race,” as a biological category, mediated through imperialist fears and desires, and sustained by the discursive, philosophical and physical apparatus of colonial medicine, Browning, Treichler, and Wald all subtly shift the area of focus to that of “culture.”

<54> In advocating this shift, I do not mean to suggest that “race” should be regarded as anything less than a vital area of study; in fact, its importance is arguably intensifying in a contemporary discursive climate where long‐discredited notions of “race” as a scientific, biological category are enjoying a resurgence, and “genetic uses of race in medicine show … troubling reconfigurations of older notions of essential difference” (Whitmarsh and Jones 7). The resurgence of “biological” race is deeply troubling, and makes the continued anthropological and sociological study of colonial and neocolonial medicine an undertaking of vital importance. Yet, as Browning, Treichler, and Wald demonstrate convincingly—and as I have tried to show here—this focus should not be at the expense of a second set of insights that, typically operating under the purview of debates on multiculturalism, have pointed out the extent to which the site of contemporary racism has ostensibly shifted from biology to “culture.” In a discursive climate where the deterministic view of “culture” “edges disturbingly close to the racist treatment of skin color or physiognomy as predictors of human behaviour” (Phillips 56), the slippages between the discursive fields of biology and “culture” have particularly profound consequences for medical representation, whose primary site of “cultural” engagement is the body.

<55> Through the generically diverse textual examples assembled in this essay, all dealing with white bodies set adrift in “infected,” “African” space (whether this space is situated on the continent of Africa or in the threatening liminal zone of Haiti through which “Africa” threatens to invade the West), I have tried to show that the most important contribution postcolonial literary and cultural analysis can make to the field of medical humanities is in documenting these slippages, and in reading the infected body as an overdetermined site where the mutual constitution and dependency of biology and “culture” are revealed. Highlighting this mutual dependency in turn has the potential to reveal points of intersection and commonality around which a more coherent postcolonial medical humanities might coalesce.

<56> While the focus of postcolonial literary and cultural theory on discourse and representation does not enable it to theorize race with a comparable depth to detailed social and anthropological histories of colonial medicine, I have tried to show how postcolonial engagements with medicine from literary‐theoretical and cultural studies perspectives can illuminate the multiple slippages and supplementations between constructions of race and “culture” along what I have termed the raciocultural axis of medical discourse. Such readings, of course, exploit a further slippage involving the term “culture”—between the cultural studies sense of the term as an aggregate of representational forms and the anthropological sense of a set of norms held by a particular ethnic or national group —in order to demonstrate that all approaches to disease and medicine are inf(l)ected by “cultural” narrative—not just those deemed “irrational” by a supposedly rational Western medical establishment. This literary/cultural‐critical perspective, then, in turn provides its own crucial supplement, presently lacking from the field of postcolonial medicine, by revealing the extent to which essentialist discourses of race and culture become mutually deterministic in discussions of disease. Understanding the logic of supplementarity underscoring this construction of perpetual determinism is a vital first step to establishing a systemic view of the representation of disease in (post)colonial contexts, and of the ongoing implications of such representational traditions for cultural theorists, communication strategists, and medical practitioners alike.

Notes

[1] I employ the terms “Western” and “non‐Western” throughout, with the customary caveats about their reinscription of binaries I seek to challenge. In the context of this essay, I use “Western” as a necessary if inadequate shorthand for a set of hegemonic discourses on health, characterized among other attributes by paternalistic and territorially defensive approaches to “foreign” disease. In this sense, the video game Resident Evil 5 also qualifies as a participant in “Western” biomedical discourse (through its deployment of Western popular cultural references, its explicit invocation of a contagious threat to a white body posed by black bodies, and what I will argue is its recourse to numerous imperialist tropes about “infectious” African space), despite being created and developed in Japan.

[2] A stunning example at once of the quasi‐mystical narrative nature of supposedly “rational” biomedical discourse in the West and of the need to attribute the AIDS pandemic to a malevolent other, the “Patient Zero” label originated in a 1984 CDC report. The report identified a Quebecois flight attendant named Gaëtan Dugas as a likely transmission vector for HIV’s introduction to the West, hypothesizing that Dugas’s promiscuity was of sufficient proportions for him to have contracted the virus elsewhere and single‐handedly initiated the epidemic in North America. By the time Dugas was immortalized, three years later, in journalist Randy Shilts’s book And the Band Played On, his villainy had attained epic proportions: no longer merely a promiscuous hedonist, Dugas had become a sadistic, deviant sexual predator, who intentionally infected unsuspecting young men at gay bathhouses. If it is surprising that the scientifically implausible (and of dubious scientific value) but narratologically appealing figure of a single infection vector for the North American AIDS epidemic remains in common circulation, it is perhaps less surprising, given the current preoccupation of popular AIDS discourse with Africa and Haiti as twin originary sources of HIV, that a 2007 article published in Proceedings of the National Academy of Sciences in the United States of America purported to identify a new “Patient Zero”—this time a single Haitian male, returning from the Congo before travelling to the US and infecting multiple patients. See Gilbert et al.

[3] An “emerging disease” is defined by the World Health Organization as “one that has appeared in a population for the first time, or that may have existed previously but is rapidly increasing in incidence or geographic range.” However, as King persuasively argues, Western approaches to emerging disease carry very specific discursive traits regarding notions of boundaries and of “foreignness,” to the extent that they constitute an” emerging diseases worldview,” which not only “furnishes […]a consistent, self‐contained ontology of epidemic disease: its causes and consequences, its patterns and prospects, the constellation of risks that it presents, and the most appropriate methods of preventing and managing those risks,” but also “comes equipped with a moral economy and historical narrative, explaining how and why we find ourselves in the situation that we do now, identifying villains and heroes, ascribing blame for failures and credit for triumphs” (767).

[4] This tension has preoccupied much of Edward Said’s writing on colonialism and literature, and forms a centrepiece of his Culture and Imperialism. It is also a central concern of Peter Edgerly Firchow’s Envisioning Africa: Racism and Imperialism in Conrad’s Heart of Darkness, which draws extensively on biographical and critical sources for its nuanced approach to the novella.

[5] The tensions between Rwanda’s Hutu majority and Tutsi minority were fostered by Belgian colonizers who, based on fashionable phrenological and racial determinist principles, believed the generally taller Tutsi people, whose facial features more closely resembled Caucasian ones, to be inherently superior to the Hutus, and treated them as such.

[6] See Bhabha. Bhabha’s essay is a radical reappropriation of the term used in Naipaul’s novel The Mimic Men. Mimicry—as reflective of a hopeless, dependent state—is a recurring feature of Naipaul’s fiction and non‐fiction.

[7] For Marxist challenges to the dominance of poststructuralism‐inflected “cultural” methodologies within postcolonial theory, see for example Parry; Ahmad. Ahluwalia, meanwhile, presents a powerful argument for the historical and political relevance of such modes of analysis to contemporary postcolonial politics.

[8] I am being somewhat selective here in focusing on the relationship between postcolonial theory and aspects of medical discourse that concern infection and disease, and not on the equally important relationship between postcolonialism and disability. There are already encouraging signs for this area of study as a subfield within postcolonial literary and cultural studies—see, for example, Barker; Barker and Murray—and the present essay attempts in part to foster thought along similar lines with respect to postcolonial theory and epidemiology.

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Acknowledgements

This essay began its life as a presentation given to the Postcolonial Studies Research Group at the University of Calgary. I am grateful to Clara Joseph, the group’s coordinator, for allowing me to present, and to Jon Kertzer, Pam McCallum, and Shaobo Xie for their insightful comments and questions. I would like also to thank Margery Fee for her extensive feedback and input into the theoretical constructions explored here, and to the anonymous peer reviewers at Reconstruction, who perceptively suggested a structure I would not otherwise have considered.

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