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Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic . By Julie Livingston . Durham, NC : Duke University Press , 2012. Pp. xvi + 228. $23.95, paperback (ISBN 978-0-8223-5342-3 ).
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Returning to Botswana in 2006 after an absence of several years, Julie Livingston noticed a marked shift in the country's health landscape. The rollout of Botswana's public antiretroviral program, which began in late 2001, had made lifesaving drugs available to an increasing number of people infected with HIV. At the same time, a rapidly growing number of people were now receiving treatment for a variety of cancers in the recently established oncology ward at Gaborone's Princess Marina Hospital. Many of these patients were suffering from new HIV-related cancers. The establishment of oncology services to assist people with virus-associated cancers, however, had also afforded Botswana the ability to diagnose a significant population of patients with cancers not related to HIV. In Improvising Medicine, Livingston offers an intimate portrait of Botswana's only oncology ward from its founding in 2001 to 2009. The ward was headed by the hospital's lone oncologist, 'Dr P.', who was an indefatigable, fiery German doctor who came to Botswana after practicing in Zimbabwe for 14 years. Drawing on eight months of ethnographic research, during...