# Volunteer economies: the politics and ethics of voluntary labour in Africa.

Alice Desclaux

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## To cite this version:

Alice Desclaux. Volunteer economies: the politics and ethics of voluntary labour in Africa.. Medicine Anthropology Theory, 2019, 6 (2), pp.133-137. 10.17157/mat.6.2.720. hal-04724716

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Volunteer economies

The politics and ethics of voluntary labour in Africa

Reviewed by Alice Desclaux

Ruth Prince and Hannah Brown, eds., *Volunteer Economies: The Politics and Ethics of Voluntary Labour in Africa*. Woodbridge, UK: James Currey, 2016. 270 pp., $34.95. ISBN: 184701139X.

Worldwide, ‘volunteerism’ has become increasingly prominent in political ideologies, social movements, and individual experience. A volunteering ethic, voluntary labour, and volunteers are all central to global humanitarianism, development, philanthropy, and political activism for social justice, in both North-South and emerging South-South interventions. This expansion of international volunteerism driven by globalization extends, coexists, or opposes more local expressions of volunteerism. The volume edited by Prince and Brown explores its meanings, social forms, and effects in the African context.

Africa is a prominent site of global humanitarian and development interventions that engage transnational volunteers. Moreover, the African volunteer has been an important figure in the last fifty years in the field of development, first in the 1960s and 1970s in support of nation building after independence, and then in the 1980s and 1990s in the ‘community development’ movement dominated by NGOs, with their rhetoric of ‘local participation’. During the 2000s, local, self-supporting volunteer organizations merged into networks and joined global organizations, for example to obtain access to AIDS treatments. During the 2010s, international and African volunteers were massively engaged in humanitarianism and development in emergency situations. However, African and international volunteers may have different relationships to labour when volunteerism may be considered an opportunity
in Africa's limited formal labour market. Before the release of *Volunteer Economies*, these aspects had not been analysed yet in a comprehensive way.

By bringing together these ethnographic studies of the various forms of volunteering, Prince and Brown are forerunners in 'unpacking' volunteerism in the African context. The book, focused on Southern and Eastern Africa (mainly South Africa, Tanzania, Lesotho, Zambia, and Kenya), considers community health workers and community-based organizations (CBOs), internships and clinical volunteering, student volunteering, and participation in medical research.

One of the book's major contributions is its combination of two approaches: studies are rooted in previous conceptualizations of the 'gift' in ethnology and anthropology, and they recognize its political and historical significance in the global neoliberal context. While volunteerism is often defined in an apolitical way as a social engagement based on moral imperatives of compassion and efficiency, the authors remind us that it is more than an expression of altruism. As shown by Mauss ([1925] 2012), giving (time and labour) calls for many kinds of countergifts, and the accompanying relationships are a key component of social systems. Globalized neoliberalism profits from volunteerism through free or cheap labour, with the ascent of volunteers who view volunteering as bringing them experience and social capital, if not money. The postwelfare state encourages volunteerism that can shift the burden of solidarity onto citizens, while blurring the boundary between labour and volunteering in the context of growing social inequalities. In Africa, volunteering is often used to accomplish basic duties through CBOs in the context of weak or fragile states. While volunteerism connects individual intimate experience and identity to macrosocial forces, Prince and Brown's volume examines its differentiation from (and intersection with) paid work at the local and global levels, and questions the favourable moral connotations attached to the figure of volunteer in the context of growing social inequalities.

The book's excellent introduction proposes a theorization of volunteerism and voluntary labour based on five 'issues': volunteering as giving, the individual and the collective, volunteering as identity, the global moral economy of compassion, and the relationship with paid work. The studies relate to a broad range of fields (health, humanitarian interventions, education, development, clinical research, etc.), calling for more comparative research.

The first section explores shifting relationships between states, communities, citizens, and volunteers in the field of health, where state investments are unstable and increasingly managed through partnerships with international institutions. In postapartheid South Africa, analysis of the many meanings of volunteering and HIV/AIDS in volunteer organizations – working beyond the common struggle to fight stigma and access treatment – points out the political challenge of shaping a complex mix of intentions towards common social goals. In
postcolonial Tanzania, a community-based malaria-control programme in an urban setting is an opportunity to investigate volunteers' activities and their production of efficiency, and to show the evolution of the urban volunteer over the past sixty years. By contrasting two configurations of the health volunteer sector and its relationship with the state, this section also highlights the vertical definition of 'landscapes of voluntarism' regarding specific pathologies. Dense landscapes (in terms of the number of organizations and diversity of scopes) are attached to pathologies that are treated as global issues (AIDS, TB, malaria), which are managed by the state under global guidance. Eboko's study of public policies related to HIV/AIDS in four African countries proposes a 'matrix for public action' for considering the connection between the state and volunteer organizations, and for comparing how they participate in the same or different epistemic communities, which might help in developing the analysis of 'volunteering local landscapes' (Eboko 2015).

The second section explores the ambiguities of volunteering when it takes place in low-income settings, where it may provide a valued opportunity to earn a living. In a nongovernmental organization in Lesotho, tensions arise over the provision of cash to participants in a development project. The expatriates see this as corrupting the spirit of volunteerism, while Basotho practitioners view these payments as legitimate and necessary. A study of participation in clinical trials in Zambia shows that participants' willingness cannot be understood as a motivation to produce new scientific knowledge for humanity, but rather the possibility to be cared for and to care for others, during and after the clinical trial. To discuss this topic in a more comprehensive way, the 'community-owned research' undertaken by collaborative teams of volunteers and AIDS scientists in the 2010s should also be considered (Otis, Bernier, and Lévy 2015). Moreover, in Africa and elsewhere, volunteering is also a way to access resources and power, a dimension not at the forefront of this book, as when dynamic and literate entrepreneurs found in the AIDS epidemic opportunities to acquire skills and access global networks, resulting in power and control over CBOs at the local level.

The following section considers the forms of exchange involved in volunteering in Africa and the complex relationship between those who volunteer and those with whom they work, through studies conducted in Tanzania. A chapter on the postindependence period shows that international volunteers inspired by President Nyerere became an important resource for development projects, a matter of political conflict and influence. Two chapters discuss contemporary medical volunteering that may be understood as 'clinical tourism' by showing the different perceptions among Tanzanian medical staff as hosts and Northern medical students as guests. They also show how a dominant rhetoric of 'doing good' obscures costs and problems, and how the narratives of global health and medical volunteering blur structural inequalities and ignore the culture of the aid industry. To some extent, the epilogue
about volunteerism in the international humanitarian organization Médecins Sans Frontières (MSF) during the West African Ebola epidemic could have been included in this section, which shows how international volunteers and national citizen workers or volunteers faced inequalities in their exposure to risk and in their treatment. Since this chapter was written, a book edited by Hofman and Au (2017) has been published, exposing the ethical dilemmas within MSF and contextualizing how responses to them were influenced by fear, beyond structural inequalities among global health workers. Considering the intersection between volunteerism and labour, an emerging object of study is ‘community health work’, a juridical form of employment in health services that has expanded since the rise of IMF-driven policies to reduce public expenses through local contracting. Though acknowledged for their experiential knowledge and requested to perform technical acts in ‘task shifting’, their status as volunteers permits institutions to avoid providing them sustainable resources.

The last section deals with volunteers' experiences and explores their moral itineraries, particularly when volunteering creates inter-individual connections across race, class, gender, and wealth barriers. The volunteer work of Kenyan students who assist children from poor families may be better understood as reinforcing a caring elite identity, while that of South Africans working in crime prevention may be seen as an expression of repentance. Volunteerism may also be analysed as a form of entrepreneurship: focusing on volunteers' moral and political agency opens prospects for further studies of volunteers as innovators or actors defining CBOs' targets and goals. Lastly, as medical ethnography studies must now consider landscapes of medical pluralism, they could also turn their attention to volunteers in pluralistic volunteering landscapes; Prince and Brown's volume provides compelling 'food for thought' to continue this analysis.

## About the author

Alice Desclaux is a senior researcher in medical anthropology at TransVIHMI, Institut de Recherche pour le Développement (French Research Institute for Sustainable Development). She works mainly in West Africa (Guinea, Senegal) and on infectious diseases (Ebola, HIV), pharmaceuticals, addiction, and outbreaks (preparedness and memories). http://www.transvihmi.ird.fr/membres/les-titulaires/desclaux-alice.

## References

* Eboko, Fred. 2015. *Repenser l'action publique en Afrique: Du sida à l'analyse de la globalisation des politiques publiques*. Paris: Karthala.

* Hofman, Michiel, and Sokhieng Au. 2017. *The Politics of Fear: Médecins Sans Frontières and the West African Ebola Epidemic*. Oxford: Oxford University Press.
Mauss, Marcel. (1925) 2012. *Essai sur le don: Forme et raison de l'échange dans les sociétés archaïques*. Paris: Presses Universitaires de France.

Otis, Joanne E., Mélina Bernier, and Joseph J. Lévy. 2015. *La recherche communautaire VIH/sida: Des savoirs engagés*. Quebec: Presses de l'Université de Québec.