Neko Mellor reviews Moving World’s latest issue, ‘Literature, Medicine, Health’ (edited by Clare Barker).

At the time of writing this review, the UK is in its seventh week of lockdown due to the covid-19 pandemic, and the latest issue of Moving Worlds, on ‘Literature, Medicine, Health’, has given me much to think about. Moving Worlds is a journal published by the University of Leeds in collaboration with Nanyang Technological University in Singapore; since its first issue in 2001, its focus is a celebration of diversity and of transcultural writings, visual artworks, and communities.  A collection of articles, creative poetry and prose, and visual artwork, many pieces in this issue originated as papers in 2018’s Northern Network for Medical Humanities Research symposium, held in Leeds. The creative pieces in this issue of MW provide more than an engagement with issues of global health: Madeleine Lee’s pithy poems about teeth and Simon Armitage’s poem, ‘Finishing It’, inscribed on a chemotherapy tablet, hold medical marvels as objects of wonder and curiosity; Avaes Mohammed’s creative prose piece, ‘Four Steps to Immunity’, and Kathy Jetñil-Kijiner’s haunting depictions of the aftermath of nuclear weapons testing in the Marshall Islands, re-centre human beings in narratives of biological processes or devastating atrocities. The articles in this issue examine a range of subjects, from genocide and cholera in Rwanda, cancer narratives from Singapore, the ‘absurdity’ of terminal illness, to perspectives on ageing, maternity, faith, and healing. Thinking literature, medicine, and health together at this critical juncture for human health is an opportunity not to be passed up.

Many of the issue’s articles are attentive to the narrative genre of ‘life writing’. Graham Matthews’ piece analyses three Singaporean breast cancer narratives alongside three narratives written by doctors turned cancer patients. Describing ‘pathographies’, a term historically used for medical case summaries, but which has come to denote personal writings on illness, Matthews persuasively affirms their value as texts which give voice to patients’ thoughts and fears about illness, treatment, and cultural ideas about particular health issues. His close-reading of key moments across all six narratives demonstrates that pathographies move medicine ‘from [maintaining] an exclusive focus on the disease to restore the human being to the centre of the medical counter’ (19), a point echoed in Michelle Chiang’s article on stories of terminal illness. For Chiang, who emphasises the important distinctions between quantitative time (seconds, minutes, hours) and qualitative time (time spent attending to personal values) following a terminal diagnosis, it is the patient’s voice which takes precedence in early end-of-life conversations. Chiang reminds us that wishes expressed in such conversations need not be profound, but rather can convey meaningful or practical wishes to enable the patient to live out their days in a comfortable way.

Frances Hemsley’s article is a compelling reading of another instance of life writing, Rwandan NGO manager Marie Béatrice Umutesi’s memoir of life in the Democratic Republic of Congo (then Zaire) following the Rwandan genocide of 1994. Umutesi’s memoir, Surviving the Slaughter: The Ordeal of a Rwandan Refugee in Zaire (2004) explores challenges after the genocide, including the cholera epidemic which overwhelmed Rwandan refugee camps in the DRC. Where Hemsley’s article is most intriguing is in its pursuit of the semantic fields of genocide and contagion which pervade Umutesi’s memoir; the spread of guerrilla warfare stories, for instance, grips several  listeners in their thrall, mobilises communities to flee across borders, and ‘[entrenches] fear and inter-ethnic hatred’ amongst listeners, like a contagious outbreak. In a linguistic move which no longer differentiates between Hutu or Tutsi, Umutesi’s narrative describes dreadful effects on ‘people’, emphasising the universal tragedy of refugees around her ‘dropping like flies’. Hemsley’s sustained recognition of the blurred distinction between genocide and epidemic, and the slow violence of exhaustion and illness, makes her article a consistently moving insight.

The front cover of Moving Worlds: Literature, Medicine, Health featuring Solomon Enos’ Polyfantastica as cover art.

The issue also takes a critical approach to depictions of colonial practices and neoliberal health development programs elsewhere in Africa. Veronica Barnsley’s article examines how reproductive health, midwives, and witches are represented in Ghanaian author Amma Darko’s novel The Housemaid (1998), whilst Amy Rushton’s article close-reads the protagonist Tambu’s dissociative, depressive tone in Zimbabwean Tsitsi Dangarembga’s This Mournable Body (2018). The latter article is sophisticated in its reading of Tambu, as Rushton remains cautious not to read her depressive manner diagnostically: instead, Rushton’s analysis of depression serves to explore its potential ‘as a critique of colonialism and its legacies’ (26), alongside passages from Fanon which illuminate colonial strategies of suppression and control. What follows is an insightful reading of the animals and folkloric creatures which function as signifiers and ­manifestations of Tambu’s distress, including crawling ants, the njuzu fish from Shona folklore, and a hyena which threatens Tambu’s sense of self. Altogether, Rushton’s article is an innovative reading of representations of colonialism in Dangarembga’s trilogy.

Veronica Barnsley’s article positions Darko’s The Housemaid as a critique of neoliberal development initiatives which seek to improve reproductive and sexual health in Ghanaian communities whilst remaining ignorant of their traditional values. Barnsley’s argument is most vivid in her examination of the role of the midwife, who remains peripheral in the novel due to characters’ economic and social access barriers, and her ‘counterpoint’ in the novel, the witch. Whilst the witch/ grandmother figure occupies a prominent and destructive position in the novel, Barnsley reads the character as central to the other characters’ sexual and reproductive politics, and thus affirms that healthcare and development initiatives cannot succeed without engagement with community networks, including elderly relatives and the traditional birth attendant. Barnsley’s criticism falls short of disentangling issues surrounding the fact that Efia’s baby, who is discovered dead and abandoned at the beginning of the novel, has Down’s Syndrome. The character Teacher summarises the community’s reaction to the birth of a child with Down’s Syndrome, ‘thank[ing] God… that the remains were found in a state beyond identifying it as having Down’s’(102). Barnsley reads this as ‘directing us towards [disability as] another route not yet taken in Ghanaian fiction’ (134). As a disability scholar myself, I would have liked to see Barnsley incorporate the baby’s Down’s syndrome into her analysis from the start, but notwithstanding this, the analysis here is a fascinating, sensitive reading of The Housemaid.

Where I feel the journal is most strident in its criticism of research and medical practices is in the three articles which explore health in relation to indigenous communities. These are by Clare Barker, Emily Timms, and Michelle Keown. Clare Barker’s readings of biological extractivism in Ann Patchett’s State of Wonder (2011) and Hanya Yanahigara’s The People in the Trees (2013) are predicated on a compelling analysis of the temporal orientations used to justify scientific colonialism. Whilst Barker argues that the former novel’s retrospective framing highlights its extictionist stance towards the indigenous Ivu’ivuans, the latter’s anticipatory rhetoric, claiming research on the Lakashi will secure the longevity of the human race, maintains a more critical relationship to the characters’ acts of biopiracy. Both novels remind us of the ways in which biocolonial research can be – problematically – presented as arising from benevolent concern. Barker’s analysis of the novels reminds us of the need to remain vigilant to exploitative research practices couched in benevolent terms.

Similarly, Emily Timms’ reading of ageing in Patricia Grace’s novel Chappy (2015) nuances contemporary romanticising discourses about intergenerational communication in Aotearoa New Zealand’s Māori familial structures. Timms’ article stresses the difficulties and obstacles elders can face in speaking, conceptualising indigenous storytelling beyond its exoticised and reductive presentation in contemporary postcolonial criticism. Timms’ article is thus a reading attentive to Grace’s positioning of intergenerational discourse as complex, multi-layered, and at times difficult. Her interpretation of the novel’s characters’ participation in recording oral histories proposes that technology can facilitate easier storytelling and hearing, but more so, demonstrates the community’s sensitivity to the processes of speaking and hearing, exploring how these might impact indigenous families’ wellbeing. Timms’ article is a sensitive handling of Māori intergenerational wellbeing and a robust challenge to reductive indigenous ageing paradigms.

Perhaps the most harrowing subject matter in the collection is Michelle Keown’s article on the ongoing legacy of the US BRAVO bomb and 67 other nuclear tests conducted in the Marshall Islands between 1946 and 1958. Although I heard Keown’s extremely moving paper on this subject at last year’s symposium in Leeds, Keown’s readings of Kathy Jetñil-Kijiner’s poem ‘History Project’ and graphic novel ‘Monster’ are still tragic to encounter a second time. Following an outline of the atrocities faced by the Marshall Islanders, including illnesses from radiation poisoning, extreme weather, and ongoing effects on childbirth, Keown presents her collaborative project with the Marshallese poet Kathy Jetñil-Kijiner and two visual artists, the Hawaiian Solomon Enos (whose vibrant Polyfantastica provides the image on the issue’s front page) and Māori-Niuean artist Munro Te Whata. Together, using elements from Jetñil-Kijiner’s poetry, and images inspired by local folklore and memory, the collaborative art pieces bear witness to the atrocities and unspoken traumas endured by the Marshall Islanders. Keown’s explication of the project emphasises that the poetry and images can recall the past ‘in a way that bald facts and statistics cannot’ (153).

Overall, both the individual articles and issue as a whole are captivating and erudite analyses of pressing contemporary issues in literature and health. What is most impressive are the issue’s wide scope, moving beyond medical humanities’ traditional Anglo-American focus to encompass writings on Africa, Asia, and the Pacific, and its attention to a multitude of physical and mental health topics, and biomedical as well as alternative treatments. As a reader whose work is about experiences of disability and chronic pain, my only (hesitant) reservation about the collection is that the issue could have included some sustained mention of disability or chronic illness. This notwithstanding, the authors in this issue of Moving Worlds and its editor, Clare Barker, are to be commended for this varied and fascinating body of writing on the intersections between literature, medicine, and health.

Neko Mellor is a PhD student in the School of English, University of Leeds. Her research engages with narratives of chronic pain, and develops a crip-materialist methodology for reading biomedical and literary chronic pain discourse. Her MA, funded by the Wellcome Trust, included a dissertation on Grace Stuart’s rheumatoid arthritis memoir Private World of Pain (1953).

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