Subsaharan Africa• MidtermsMidterms• Geography in the NewsGeography in the News

– Due in 44 daysDue in 44 days– 15 sources?15 sources?

• Subsaharan AfricaSubsaharan Africa– Development colonial legacyDevelopment colonial legacy– Medical geography & diseaseMedical geography & disease– Cultural patternsCultural patterns

Colonial Legacy• Boundaries & intertribal antagonism (e.g., Rwanda)

• Transportation network• Interior to coastal ports

• Dual economy• 70% of labour force in agriculture • Cash crops for export: cocoa, coffee, tea, cotton• Subsistence agriculture (maize, millet, sorghum, tubers, plantain)• Land tenure issues, need for land reform

• Colonial institutions• Government and legal framework

Medical Geography• Epidemiology• Africa is uniquely vulnerable

– High disease incidence and diffusion– Widespread nutritional deficiencies– Vectors and hosts

• Spread of disease– Endemic– Epidemic– Pandemic

Medical Geography• Endemic disease

• Infects large numbers without rapid death• Equilibrium & persistent ill-health• Typically endemic to a region

– Hepatitis– STDs or STIs (formerly venereal diseases)– Parasites e.g. hookworm – chronic anemia– Schistosomiasis (Bilharzia)

• snail borne blood fluke– River Blindness (Onchocerciasis)

• parasitic worm vectored by black fly

Medical Geography• Epidemic

• Local or regional dimensions, • Often acute onset• Distribution often depends on vector

– Sleeping Sickness• Vectored by tsetse fly• Endemic in wildlife but kills Bos indicus/Bos taurus• No ‘domestic’ cattle breeds on African savannah

Medical Geography• Pandemic

• Spread is “worldwide”– Mosquito borne:

• Yellow Fever• Malaria

– DDT

Medical Geography• Imminent Pandemic?

– Spanish influenza 1918-19• H1N1: 20-50 million deaths worldwide

– Avian influenza?• H5N1

• AIDS– Pandemic since 1990s– ARV drugs in developed countries e.g. AZT– 80% of 37 million infected are in Africa– Shifted from equatorial belt to southern Africa

• Botswana, Namibia, Zimbabwe• 25% of 15-49 population infected• Life expectancy is declining• Impact on labour force and economic development• Population declines of 10-20%

– Bubonic plague in Europe– Small pox among indigenous people of Americas

MEDICAL GEOGRAPHY

AIDS Transmission in the U.S.

SOURCE: UNAIDS, 2000

Growing Incidence of AIDS in Africa

CULTURAL PATTERNS• Population distribution• African languages

– Colonial lingua franca• Swahili• Hausa

– Multilingualism• Religions

– Christianity– Islam– Tribal religions

POPULATIONDISTRIBUTION

Traumatized children after massacre of 1,000 in Congo

Reprise

GeneralizedLanguage Regions of

Africa

REGIONS OF SUBSAHARAN AFRICA