Type of Document	MD Thesis
Author	Al-Samarrai, Teeb
Author's Email Address	Teeb.Al-Samarrai@yale.edu
URN	etd-06272006-095841
Title	Medicine in the Margins: Access, resistance and health care utilization among the Tuareg of Niger
Degree	MD
Department	Medicine
Advisory Committee	Advisor Name Title Naomi Rogers Committee Chair
Keywords	Niger Tuareg people western medicine health care delivery health care utilization political resistance sedentarization social resistance
Date of Defense	0000-00-00
Availability	mixed
Abstract This thesis explores the historical, cultural and social reasons for the wariness that the nomadic Tuareg of Niger have towards Western medicine and medical practitioners. I give a historical account of their interactions with and resistance to the French colonial administration and the postcolonial state of Niger and how this resistance to Western medicine and health clinics was an embodied form of political and social resistance to governmentality and state attempts at sedentarization. I provide historical example of when health care delivery was successful and was embraced rather than resisted as well as the ways in which the Tuareg have not only integrated Western medicines into their lives but the ways in which these often scarce medicines are distributed to the community as a whole. I performed a systematic review of the medical, public health, and social science literature examining published and unpublished documents and doctoral dissertations on the health of the Tuareg and history of Niger. I also conducted interviews with journalists, anthropologists, humanitarian aid workers and a physician that have worked with the Tuareg in Niger. Despite this resistance and physical remoteness there are also success stories of how trust can be achieved and health care successfully delivered to the Tuareg. This research demonstrates that even with enormous cultural, social and political resistance and under circumstances of poor infrastructure and limited resources, Western medicine is not only desired but can be delivered to remote populations. In my conclusion, I discuss the differential impact that sedentarization and recent famines have had on the way of life of the Tuareg and their access to health care.
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