Pharmacie Gasy: the Neocolonial Instrumentalization of Toxicity to Discredit Healing in Madagascar

TEXT BY CHANELLE ADAMS – ILLUSTRATIONS BY SARAH BOISARD

Madagascar (Repoblikan’i Madagasikara) is internationally recognized for its distinct ecological composition. The fourth largest island in the world is home to over 200,000 plant and animal species of which at least 80 percent are native to Madagascar. Hundreds of these plants are expertly recruited in practices of Malagasy medicine, or pharmacie gasy, by specialists throughout the island’s six provinces.

It is said among Malagasy elders that the antidote to any venom, sting, or poison can be found in your immediate surroundings — that is, if you know how. Pharmacie gasy, often employing botanicals as medicine (fanafody), is a system of relationships and materials that bring about a change in the patient’s psyche or body. Patients of pharmacie gasy display variety of concerns with symptoms that range beyond Cartesian dualism: illness and sickness (marary and arety) such as syphilis and migraines can be attributed to bad fortune or jealousy, all considered part of the social body of fahasalamana (well-being). An attunement to pharmacie gasy, both spiritually ordained and learned, necessitates a metaphysical turn to the ancestral realm. Without this orientation, many vazaha (foreigners) have a restricted view of what pharmacie gasy has historically been and what it can be. To justify the exploitation and appropriation of phamarcie gasy for financial and political gain, colonial medicine and Big Pharma have relied on categorizing pharmacie gasy as largely “toxic” and in need of Western governance. Classifying pharmacie gasy as dangerous recruits colonial science to enact a disciplinary power over Malagasy medicine. With health and healing as intimately linked to self-knowledge and self-determination of individuals and communities, the subjugation of pharmacie gasy raises serious questions about sovereignty. What would it mean to reconsider “toxicity” not as a neutral biological classification, but as a tool of colonial governance which condemns Malagasy knowledge production?

Colonial Medical Anxiety and (Un)Reliable Bodies of Knowledge ///

France’s ten-month military campaign to colonize Madagascar in 1895 was arguably one of the worst medical disasters of any European invasion in Africa. Queen Ranavalona III (r. 1883-1897) of roughly two thirds of Madagascar refused to accept an Anglo-Franco agreement that assumed French protectorate over the island after the first Franco-Hova War (1883-1885). In response to the Merina Queen’s defiance, the French sunk their teeth in deeper, initiating a second Franco-Hova War in a desperate attempt to claim their illegally acquired territorial “right.” Although ultimately victorious in acquiring the red island, it was not without humiliation for the colonizers. Out of the roughly six thousand French casualties, only twenty were the result of actual combat: the rest fell ill to malaria, dysentery and typhoid. Unfamiliar with Madagascar’s unique landscape, the French were unable to recognize the plants in their surroundings which could have cured the very diseases that decimated their colonial troops. With tropical disease central to 19th century colonial anxiety, phyto-medicine became seen as an issue of national security. A potential threat to the bio-order imposed by colonialism, scientists and colonizers engaged in the surveillance of plants. Popular literature on the genre of man-eating trees and accounts of the plant tanghin used in judicial executions circulated in the fearful colonial imagination. Informed by racist fear, colonizers and missionaries in Madagascar were wary of both the Malagasy people and the natural environment — each plant possessing both the threat of posion and the potential to relieve unfavorable economic and physical conditions. Rather than regarding practitioners of Malagasy pharmacie gasy, such as ombiasy (healers), massage therapists, and renin-jaza (mid-wives), as specialists, resistors and diviners, the colonial archive systematically exhibits a stance of suspicion and skepticism towards pharmacie gasy and its knowledgeable practitioners. French colonial botanists, missionaries and administrators positioned themselves as filters who could extract the truth, discerning “real” knowledge (objective, elegant, simple, and universal) from “traditional knowledge” or that which is depicted as subjective, anecdotal, impure and biased. By re-naming, re-categorizing, and re-orienting relationship between materials, colonial scientists claimed to be the arbiters of facts and true knowledge — discarding that which is “traditional,” “irrational,” “dangerous,” and “toxic.” By defining pharmacie gasy as external to the scientific method, biomedicine has re-appropriated its practices under the guise of safety, effectiveness, and evidence. This paternalistic mechanism of usurping power relies upon the reinforcement of knowledge hierarchies based on biomedical binaries of harm/heal, rational/irrational, knowledge/ignorance, cure/poison, and good/bad. When pharmacie gasy and its community of practice are held on trial, these colonial dichotomies are fortified.

The Imposition of Biomedical “Objective” Filters as Mechanisms of Control and Surveillance ///

The colonial preoccupation with safety and security has been mobilized to discredit therapeutic plant knowledge of midwives, rural folks, and especially those of the Global South. The concept of “toxicity” has been, and continues to be, used to discount, and silence knowledge production across national borders and knowledge regimes. The filters of regulation, standardization, and even intellectual property rights, monopolize public health agendas, eclipsing the larger concerns of toxic sovereignty and healthcare which does not rely upon external valuation and divination of meaning from Western bio-medicine.

Toxicology, a modern branch of pharmacology, rose in Western relevance in the 19th century. A science based on suspicion and concern, toxicology deals with poisons, toxins and venoms, or that which interferes with normative biophysical processes at work. Like agents of disease, poisons are a threat to the immunological force field of the dominant bio-order. The very criteria for systemized boundaries around what is considered dangerous, to whom, in what amount, and under which conditions, is a culturally situated value-judgment used to discipline knowledge about the body into a European biomedical logic.

Maintaining an uncomplicated view of colonial medicine propagates of the tight subject-spatial positioning which Malagasy people inhabit today as knowledge producers. Evidence from an “objective” perspective was instituted during formal colonialism and is still seen as necessary to appraise the true value of Madagascar’s natural resources. As a result, Malagasy people living closest to these resources have been framed as destructive to the environment and incapable of producing knowledge about their own tanindrazana (ancestral land).

The concern of toxicity and danger is used to legitimize the logic that Malagasy phyto-medicine requires interventionist containment and governance. By controlling the parameters of danger and surveillance of harm, toxicology is a political force that governs biopolitical questions of about who has the right to control that which can make life and let die — and what materials and beliefs are permissible to use for healing. Rather than being framed by fears of safety, contamination, and secrecy, what if we viewed the sustained use of medico-botanicals in pharmacie gasy as a political stance beyond mere survival but of knowledge, health, and land sovereignty?

Molecular Governance of Pharmacie Gasy ///

While daily operations of scientific practices are often defined by borders between the lungs and industrial waste particles or brain membranes and serotonin, we must also account for epistemic borders which are being policed. Questions of health and healing are inseparable from questions of bio-security and knowledge sovereignty, which is what makes pharmacology and pharmaceutical industry the center of many intellectual property and cognitive justice debates.

At face value, pharmacie gasy is discredited for being outside or alien to biomedicine, but this is not entirely true. The booming pharmaceutical and cosmetic industries profit from the established exploitation routes of colonialism, propagating a bio-capitalist framework of governance that micrologizes entire bodies of knowledge, reducing it to a transportable commodity often in synthesized capsule form. Chemical compounds found in plants are reproduced synthetically in laboratories to create highly lucrative products for the pharmaceutical industry — the GDP of the pharmaceutical market from the USA alone is roughly 30 times Madagascar’s total GDP.

There have been a few notable instances of times when plants from pharmacie gasy have been adapted into biomedical system by being mutated into forms that appeal to biomedical norms. Take for example, the presence of Ravintsara (also known as hazomanitra and havozo) which appears as an essential oil on the shelves of many pharmacies in France, displayed as lefgitimate only in their validation by modern science. Similarly, molecules extracted from the Madagascar plants pennywort and periwinkle have been synthesized from into pharmaceutical products for wound treatment and cancer, respectively. This process affirms the dominant paradigm that the benefits of plant therapeutics are extractable and reproducible through mastery and encapsulation. Madécasse acid, is a molecule extracted from pennywort (Vonenina or Centella asisatic in the Linnaean nomenclature system) in the 1960s, bears the namesake of its nationality — this is no coincidence, the molecular unit is a scientific metaphor based on enclosure, constructed during the rise of nation states and borders. Claims to national possessions include molecular inventories of the living and non-living in a given territory. Both the nation and molecule define the parameters of imagined interactions and relationships in which the natural becomes the national and vice versa.

Used in Madécasse, a wound treatment marketed by French pharmaceutical industry, the pennywort has become a case study of national triumph — a victorious narrative of how a European-trained Malagasy scientist, Ratsimamanga, in partnership with a French Botanist Boiteau, who achieved recognition for phamarcie gasy in the global health arena — and an emblematic anecdote for cross-cultural scientific partnerships. Meanwhile, the story of the Madagascar rosy periwinkle is often used as an example of lack of Malagasy recognition at all in drug production. The argument goes that the use of the periwinkle in cancer treatments, largely in the Global North, was informed by Malagasy “traditional knowledge.” Questions of intellectual property and mutual benefit tend to stop at the national frontier, at which only the most elite Malagasy people, such as Ratsimamanga can be portrayed as pioneers of “traditional medicine” and plant specialists without European medical training are considered ignorant and uncapable of expertise — which is moralized as dangerous.

Most provocations for bio-prosperity remains within the logics that biomedicine must continue to act as a filter, protecting patients away from potentially dangerous plants and ways of healing. Controlling and standardizing medicine by international conventions is one that relies upon the idea that in the “wrong” hands, these medicines are dangerous. As a result, French colonial botany, has and continues to be, an entrepreneurial endeavor to appropriate phyto-pharmaceuticals for national gain in the medicinal and cosmetic industries. Rather than being imagined as integrated in interpersonal network which incorporates both the living and dead, the social and bodily, the concrete and unfathomable, pharmacie gasy becomes imagined as regulatable molecular structures. However, these imposed colonial taxonomies and the filter of toxicity are unsuitable units of to measure the value of pharmacie gasy. As many Malagasy healers argue, the powers of pharmacie gasy are not extractable — healing derives not only from ties to materials, but also from social relationships and land.

There is a saying that pharmacie gasy only “works” in Madagascar. Exporting materials does not always work, which is why patients inhabiting nearby islands frequently return to Madagascar to be treated for illnesses. Crossing the Indian Ocean, ody gasy is thought to lose healing potential, and in that sense, pharmacie gasy itself escapes confinement. Malagasy medico-botanical knowledge production and innovation is regarded as a suspicious threat to the dominant bio-order precisely because of its power. Unable to be packaged and surveilled, pharmacie gasy has, and always will, operate on the terms of the ancestors. Building a capsule around a substance and giving it a name does not mean it can be contained, or ever was containable. As long as the power of healing is filtered through the molecular unit, the game is rigged. The appropriation of knowledge at play is obscured by remaining on the scale of the molecular, biological life units which do not encompass the culturally bound practices of pharmacie gasy.

 

A Toxicity That Heals // To Heal and-To Harm ///
Where is the line between therapeutic and toxicity? And who gets to decide? What if toxicity as it is being mobilized is not always “bad,” but actually central to health and well-being? In pointing fingers at the dangers of marginalized forms of healing, biomedicine diverts attention from the fact that it itself is trapped in the pharmakon, that a substance can be both beneficial and detrimental to a person at the same time. Poison, too, can be medicine. In fact, the two are often one and the same.

In truth, “toxicity” is everywhere in the Global North, in material forms such as pesticides and certain plastics, to behavioral norms such as capitalist exploitation and interpersonal competition. In the biomedical world, there many responses to illness which involve treatments that could be considered poisonous, but are generally recognized as valid therapeutic practices. Antibiotics, which are known to cause a myriad of health complications, and cancer radiation treatments, which damage even the “good” cells, are considered to have benefits that outweigh the threats these medicines pose to the body (see: side effects).

“Toxicity”, thus, is inseparable from cultural allegiances. The use of purgatives and fever-inducing treatments which is not unfamiliar to pharmacie gasy, may appear unnecessary or toxic to the Global North’s palate. Often these tastes are affected by beliefs about the root of the illness and the health options available, where a patient may prefer a different treatment method. The concern with toxicity is not necessarily concerned with the existence of toxicity, but moreso the threshold at which the benefits are perceived to be outweighed by the costs. Discrediting pharmacie gasy on the basis of “toxicity” does not actually carry much weight by its own logic, other than serving to justify its appropriation. Instead, it reveals an unwillingness to recognize pharmacie gasy on its own terms. Where one might see danger or threat or illness, another may see power, fate, and justice. This historical and contemporary look at the pharmacie gasy exposes larger questions about colonial mechanisms of knowledge domination. Marginalized subjects continue to be treated as suspicious and unreliable knowledge producers, not because we are untruthful, because what we know is dangerous to the dominant world order. By describing where the biomedical framework of “toxicity”, I hope to provoke the reflection that where we locate threat and danger are deeply political questions. By locating poison elsewhere, the sources of global toxicity shirk responsibility and fall out of focus.

/// Special thanks to my collaborators and comrades, Sandra, Mody, Paulas, Sylvie, Marmena, Louis-Philippe, who have patiently informed and lovingly pushed my reflections further. ///