Based on extensive field research in the Manianga region of the Lower Congo, Health in a Fragile State is an anthropological account of public health and health care after the collapse of the Congolese state in the 1980s and 1990s. This work brings into focus John M. Janzen's earlier books on African health and healing, revealing the collaborative effort by local, national, and international agencies to create viable alternative institutions to those that represented the centralized state. This book documents and analyzes the realignment of existing institutions and the creation of new ones that shape health and healing.
Janzen explores the manner in which power and information, including science, are legitimized in the preservation and improvement of health. Institutional validity and knowledge empower citizens and health practitioners to gain the upper hand over the region's principal diseases, including malaria, tuberculosis, typhoid, and HIV/AIDS.

John M. Janzen is a professor emeritus of anthropology at the University of Kansas. He is the author of The Quest for Therapy in Lower Zaire; Lemba, 1650–1930: A Drum of Affliction in Africa and the New World; Ngoma: Discourses of Healing in Central and Southern Africa; and many articles on health, healing, religion, and society in Central Africa and the Atlantic diaspora.

CONTENTS
List of Illustrations ix
Preface and Acknowledgments xiii
List of Abbreviations xvii
Introduction 3
Part I: A History of Population and Disease in the Lower Congo
1 Population Decline and Rise 41
2 Postcolonial Population and Disease Trends 65
Part II: The Social Reproduction of Health
3 Health in Household, Family, and Clan 89
4 Public Health and Health Care Institutions, Reconfigured 109
5 Rejoicing in Our Bodies: Popular Meanings of Health 145
Part III: The Legitimation of Power and Knowledge
6 Dumuna: Creating Authority from Below 159
7 Science, Sorcery, and Spirit 190
8 Legitimation and Disease Control 214
Conclusion 229
Notes 235
Bibliography 243
Index 251