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Past Imperfect: Time and African Decolonization, 1945–1960

basic health care. Following the civil wars in the region, the international community – referred to as the crisis caravan – “invested most of their resources in a narrow vision of security that left little for rebuilding health facilities – and less than a little for training a new health workforce” (421). Efforts to rebuild health facilities and train health professionals, following the war, were deemed “not cost-effective” (420) by international health experts, and the focus, as always, was on containment of the diseases. It is because of this “expert mercy” that to be sick in upper West Africa means, more or less, the same as it did a century ago. Paul Farmer dedicated his life to serving people without access to basic health care and advocating for their rights. He passed away earlier this year. This book is a testament to his conviction and belief that until “... health care remains largely a commodity rather than a right, it’s likely that the strengthening of health systems will continue to spark only transient enthusiasm among history’s victors – and only when calamity strikes” (503). The stray into colonial history is longwinded, but Farmer later connects it with the fevers that have long characterized this region. Similarly, the book is lengthy, but it is an engaging page-turner. Farmer’s arguments on the coloniality of public health have been echoed by other authors in recent years (see Packard 2016; Richardson 2020); however, what makes this work unique is its voice. The accounts of this book are from those who are unlikely to have a chance to narrate their experiences. To me, this underscores the importance of social medicine: understanding social pathogens and providing care. As such, I would recommend this book to every student of African history, social medicine, public health and medical anthropology.