Reworking Efficacy: The Social Life of Medicine in Northern Togo

Thumbnail Image



Journal Title

Journal ISSN

Volume Title

Repository Usage Stats



When considering the local, indigenous, “traditional” healing practices of non-Western societies, Euro-Americans often ask whether or not they are efficacious – “do they work?” Posed from a biomedical paradigm, the concept of work adheres to a narrow definition. This thesis seeks to expand constrained prevailing views of medical efficacy, challenging conception of the “work” medical systems perform. Rooted in ethnographic fieldwork conducted in the village of Kuwdé, Northern Togo, I apply the question of work to the Kabre local medical system. I consider how the purposeful distribution of remedies among houses in Kuwdé orients the individual body to community, clan, and history through health and disease. I draw upon theories of embodiment, relationality, and power to show that a medical system does social, relational, and political work as well as physiological work. In doing so, I aim to move from a conception of health solely as biological-pathway-to-biological-impact, to situating health in its social and relational dimensions. I then engage with the field of global health, arguing that an expanded notion of efficacy and work may, in turn, improve the delivery of biomedical care. It is my hope that this project cultivates awareness of how definitions of efficacy frame the lived experience and practice of medicine.





Middleton, Alexandra (2013). Reworking Efficacy: The Social Life of Medicine in Northern Togo. Honors thesis, Duke University. Retrieved from

Dukes student scholarship is made available to the public using a Creative Commons Attribution / Non-commercial / No derivative (CC-BY-NC-ND) license.