AO: In her preface, she notes: I am “refusing to choose between categories. … I am both a Western and a West African scientists. … a bicontinental existence currently contributes more than a full-time scientific employment in Nigeria. … I know many other African scientists who have straddled two continents, making the most of the increased “networkedness” of science today. (x).
AO: Okeke notes that she gets asked regularly about how molecular biology relates to health in Africa and argues that “unveiling the strong connections between science and modern medicine is a principal objective of this work.” She acknowledges that “the conscious decision to take some time away from my lab to write this manuscript is my response to the realization that it might be more important to communicate the magnitude and importance of laboratory deficits in general and diagnostic shortfalls in particular than to continue to chip away at these problems myself, or within small collaborative groups.”
AO: Okeke notes that the diversity of endemic life-threatening infections and limited public health resources on the continent make the need for basic laboratory diagnostic support even more acute than in other parts of the world.
AO: diagnostic science in African hospital laboratory
AO: Okeke notes that she has watched the “ivory tower tarnish in the face of structural adjustment programs at the national (Nigerian) level.” She notes in particular the material decline of science education. She notes that by the 1990s, most of the biology papers in top science journals were unintelligible to Nigerian grad students and then the library did not even stock the journals. (ix).
AO: Okeke is interested in how laboratory science in Africa can be strengthened to improve diagnostic practices.
AO: Okeke’s work contrasts with some of the other work on STS in Africa because of her knowledge as a practicing pharmacist and microbiologist in Nigeria. She notes her research interest started when a paper she wrote about bacteria causing diarrhea was critiqued for its outdated and imprecise “standard” methods. In searching for a response, Okeke realized the sheer and overwhelming scope of the diagnostic gaps across Africa (xi). She is careful to write: “I hope I do not convey the impression that there are no diagnostic facilities in Africa.” She notes: “It is important to emphasize that the scale and scope of the problem described in this book is heterogeneous. … The argument I try to make here is that every African patient should have appropriate diagnostic access and most currently do not.” (xii). Based on her subject position and experiences, she is thus able to put together a nuanced but compelling call for greater intervention in the development of lab capacity on the continent. She is especially focused on techno and macro levels of analysis.