Transnational Therapy Management, Affective Circuits, and State Regulation: Senegal River Valley Migrants in France

Ethnographies of healing practices in Africa have underlined how medical decision-making is often a collective enterprise engaging kin, friends and local practitioners in therapy management groups. In the context of African migrations to Europe, much remains to explore regarding whether and how such “therapy management groups” persist and function on a transnational scale and how health advice and resources circulate between immigrants and their kin and social networks in their societies of origin. Our research over the past decade on the health of West-African immigrants in France (most of whom come from the Senegal River Valley region encompassing Mali, Mauritania, and Senegal) indicates that illness continues to mobilize actors and strategies beyond the confines of French borders. The highly regulated nature of today's immigration, however, affects these transnational “healthcare circuits”. Since the end of official, state-sponsored labor migration in the 1970s, a number of legislative decisions have progressively restricted conditions of entry. A series of laws and amendments addressing gender, marital status, and family composition have threatened Africans residing in France. Immigration status, in turn, shapes access to health care in France and the ways in which transnational therapy management unfolds. By means of two case studies, we analyze how circuits of care are reconfigured between immigrants in France and kin “at home” and the extent to which they are facilitated, constrained, or impeded by this state regulative context.