Paper short abstract:

Cross-sector collaborations bring new diagnostic, treatment, and counselling services for HIV and AIDS in northern Republic of Congo. Resulting struggles over knowledge, healing power, and access to care reveal disparate conceptions of truth, illness, and responsibility.

Paper long abstract:

Parts of the northwestern equatorial forest are experiencing epochal transformations in demographic composition, in resource management and biodiversity, and in new forms of integration with both national and globalized economies. In the Republic of Congo, the northern Sangha province and its capital, Ouesso, are now poles of migration and development as the country moves onward in reconstruction and reconciliation after two civil wars. New road, air, and ferry links expand contact and exchange both with Brazzaville, far downriver, and with adjacent southeast Cameroon.

This paper considers some of the corresponding changes in health services and modalities in Ouesso and in nearby logging towns along the Sangha river. It contrasts postsocialist and pre-ARV circumstances of the 1990s with recent developments spurred by new national government, greater church and NGO investment, rapid population growth, intensified logging and road-building, and forest clearing and settlement.

In these growing towns, cross-sector collaborations bring new diagnostic, treatment, and counselling services to challenge local interpretations and existing arrangements that cope with HIV and AIDS. Recently-founded non-profits coordinate with expanded state health services, making referrals to church-aided clinics run by logging companies and funded by international donors. Resulting struggles over knowledge, healing power, and access to care reveal disparate understandings of truth, illness, and responsibility. They help us see how these social technologies are changing imaginations and conditions of health in relation to the long-term histories and diverse lifeways of this region.