I joined colleagues as part of the research team on chronic disease in Africa after working on a long term project on the history of cancer in eastern Africa. This historical and ethnographic research on the Uganda Cancer Institute is just beginning to come out in a variety of different forms. Briefly, this site began as a chemotherapy clinical trials center dedicated to researching cancers that were common in eastern Africa and highly responsive to treatments available at the time. Today the site persists as the major site of public oncological goods for a population catchment of about 40 million living in the Great Lakes region.
One way of telling the story of this site is through photographs. Five years ago, I received a large box from John Ziegler, the founding director of the Uganda Cancer Institute. The box contained article proofs, a handful of old letters, and hundreds of photographs of patients taken by Mulago Hospital’s department of medical illustration in the 1960s. Some of the photographs captured the extraordinary deformities common in Burkitt’s lymphoma—weeping eyes, bulging necks, swollen jaws. I found these images deeply upsetting. Some children in the photographs were visibly crying from the pain of their jaw tumors. Other patients, stripped bare, had the camera focused on their swollen genitals or tumors breaking through the skin. But the photos also included gorgeous, intimate snapshots of everyday life at the Institute—ward rounds, chemotherapy administration, comforting patients.
Andrea Stultiens and I have collaborated over the past several years to bring this photo archive into conversation with the Institute’s present. The result is a book of Ziegler’s historical photographs, excerpts from my field notes, and Stultiens’s contemporary photographs.
In April, we launched Staying Alive: documenting the Uganda Cancer Institute in Kampala at the Institute’s weekly Research in Progress meeting. Nurses, physicians, laboratory technicians, and other colleagues joined us for milk tea and conversation at eight in the morning. We read several short pieces from the book, as colleagues paged through the images. There is an elegiac quality to this object. When I shared it with the pediatric oncologist who made so much of the contemporary photographic and ethnographic research possible in 2012, she went through the portraits of pediatric patients one by one, remembering heartbreaking relapses, valiant caretakers, haunting deaths. But the book also stokes a real sense of joy and accomplishment about the Institute’s transformation over the decades.
This work ignited many lively debates and quiet reflections about what to do with these photographs along the way. On the one hand, there was a desire to stuff the photographs of patients taken by the medical illustration department deep into a drawer. On the other hand, I felt these images told a powerful story about cancer and change over time in a way that words could not. These photographs highlighted powerful, if not upsetting, continuities. Going through the old patient photographs with a colleague, and he remarked that “the face of the disease is exactly the same” as it was fifty years ago.
In August 2017, the Uganda Cancer Institute will celebrate its Golden Jubilee. No doubt these conversations will continue as we share Staying Alive in several exhibition spaces and conferences revisiting the Institute’s past and contemplating its future.