In Healing Roots: Anthropology in Life and Medicine, Julie Laplante challenges the dominant approach to testing, trialing, and legitimizing medicine meant for use in humans—the randomized control trial (RCT)—and ways of “knowing” medicine overall. The object of her study, a preclinical trial of the widely used Artemisia afra plant of South Africa, set out to marry biochemical approaches to creating and evaluating a medicine with traditional approaches. In this book, Laplante aims to “trace how an indigenous plant is made to appear within a preclinical trial to test its efficacy against the tuberculosis pandemic … [and] follow a wild indigenous bush in its trails and trials of becoming a biopharmaceutical” (pp. 1–2).
Foremost among her critiques of the RCT model is its lack of holism and its disconnect with the way A. afra is (and has been for centuries) used and considered by indigenous people. Laplante compares the RCT with traditional healing practices done by bossiedoktors and isangoma in South Africa. These traditional healers embrace ideas such as livity—a Rastafarian ideology that entails living, being, and interacting in and with the world in the everyday—and place a heavy importance on aesthetics, especially sound, in healing. Laplante contrasts this with the RCT process, opining that “the notion of ‘life itself’ is central to the life sciences, yet the life sciences are utterly detached from what makes a person alive” (p. 212). This, she believes, leads to an ignorance of the potential of humans and plants to mutually affect one another and can impede the healing process rather than help it. However, some statements—such as “how things are felt … surely plays into the ways a body will react (or not) to the same molecule” (p. 59)—would have been strengthened by her providing relevant citations or further background information for those readers (myself included) with little knowledge regarding the mechanisms of biochemistry.
One primary example of this difference in ideology between practitioners of traditional medicine and biomedical researchers is that of the methods of cultivating the A. afra used in the preclinical trial: One farm mass cultivates A. afra, ensuring as much similarity among the various bushes as is possible, which indigenous healers believe removes “life” from the plants. In contrast, indigenous communities believe a plant achieves its highest efficacy by growing organically, without human meddling, in nature—which could be in a wild forest or the front yard of a house—its relationship with humans being, again, organic. It is also the difference between the biomedical researchers’ quantitative techniques of extracting isolated compounds from an A. afra sample for medical use and bossiedoktors and isangoma using the plant in its entirety.
Laplante adds that knowing medicine from a biomedical, biochemical standpoint is a very different type of knowing than that which traditional healers employ. She suggests that the latter hold a superior type of knowledge and that the RCTs conducted under the former standpoint are “restrictive and perhaps harmful and demeaning to human dignity” (pp. 255–256). She also focuses on the implications of subjecting plants accompanied by a vast array of indigenous knowledge to the practices typical in preclinical trials and RCTs—including that it is a form of delegitimation of indigenous knowledge and perhaps even a form of colonization of knowledge.
The issues that Laplante focuses her attention on are timely and important, especially in this age of Big Pharma. However, she devotes a majority of her attention to the beliefs and practices of the aforementioned traditional healers, leaving RCT practices comparatively underexplored. After reading the book’s introduction and Laplante’s goal to follow a plant’s path to becoming a biopharmaceutical, I looked forward to an in-depth exploration of a potential medicine’s moving through a preclinical trial but felt that this area was underexplored. Additionally, aside from a brief description of the form of A. afra used in the preclinical trial and another relatively short explanation of the traditional uses of the plant, little attention was focused on the plant itself. Instead, the primary focus of the book was traditional healing practices in South Africa, particularly the underlying ideologies that govern them.
Overall, Laplante’s Healing Roots, focusing on the tensions between the biomedical and traditional healing–based ways of making a medicine is an informative and important contribution to the literature. As such, it would have intrinsic value in the classroom, primarily for graduate-level students with specific interests in South Africa and the crossroads of ethnopharmacology and biomedicine. However, it was less focused on following a plant through the aforementioned “trails and trials of becoming a biopharmaceutical” (p. 2) than on an in-depth exploration of South African healing practices and ideologies and the dissonance between how biomedical researchers and traditional South African healers view the process of creating an effective medicine.