Inheriting Otherwise

Inheriting Otherwise: Sickle Cell and the Excesses of Genetic Medicine in Tanzania is my ongoing book project, based on 24 months of ethnographic fieldwork in Dar es Salaam, Mwanza, and Zanzibar from 2018 to 2020. The project considers the emergent prioritization of sickle cell disease as a national health priority across Tanzania, and theorizes the ways in which genetic disease inheritance is entangled with other forms of embodied kinship and care that overspill the boundaries of biomedical knowledge production.

Since its identification in the early twentieth century, sickle cell disease has been deeply entangled with racial science, colonial medicine, and the redesignation of Blackness as biological and heritable, especially in Europe and the United States. Historians and anthropologists have shown how this heritable blood disease became emblematic of racial health inequality, shaped by eugenic imaginaries and structural neglect. Over the past decade, however, sickle cell has been rearticulated within a different global moment: the expansion of African-led genomic research and genetic medicine. In Tanzania, this movement marks a shift toward Afrocentric biomedical sovereignty, as Tanzanian researchers build local intellectual and material infrastructure for genetic research and disease care rather than serving as assistants or data collectors for Northern genomics laboratories. As sickle cell increasingly becomes a national health priority, growing numbers of Tanzanian families are drawn into an expanding infrastructure of genetic disease diagnosis and care. My book emerges from this moment and analyzes the articulation of Afrocentric genetic medicine with its constitutive outsides: the forms of inheritance that persist with, through, and beyond the gene.

Inheriting Otherwise argues that genetic medicine operates through fixing inheritance: anchoring it in linear temporal origins, mapping it to stable spatial populations, bounding it as molecular transmission, and organizing it within nuclear families. This fixity, while necessary for durable institutional care, also risks unintentionally participating in what Sylvia Wynter calls "biocentrism": the reduction of humanity to biology, naturalizing racial, colonial, patriarchal, and capitalist hierarchies. As genetic medicine expands in Tanzania, it risks entrenching biocentrism even while staking a claim to African biomedical sovereignty. 

However, Inheriting Otherwise also shows that genetic inheritance does not totalize. Following sickle cell diagnosis as it circulates through hospitals, homes, churches, and beyond, I trace its excesses: forms of inheritance and bodily kin relation that overflow genetic medicine's fixities. In other words, Inheriting Otherwise grapples with the political complexities of sovereign, Afrocentric genetic medicine while demonstrating that sovereignty need not appeal to biocentrism's assertion of a singular truth.