Fever pitch: Coloniality and contention within community health's yellow fever response in Kenya.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 101256323 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-1706 (Electronic) Linking ISSN: 17441692 NLM ISO Abbreviation: Glob Public Health Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: Abingdon, UK : Routledge, c2006-

Yellow Fever*/prevention & control ; Yellow Fever*/epidemiology ; Yellow Fever Vaccine*/administration & dosage ; Community Health Workers*/psychology ; Colonialism*; Kenya/epidemiology ; Humans ; Focus Groups ; Interviews as Topic ; Anthropology, Cultural

In January 2022, a number of Yellow Fever cases were identified in Kenya's Isiolo County for the first time, triggering a national-level response centred on vaccinating residents. 181,000 people were vaccinated in July, around 72% of the eligible population. In the face of this ostensible success, this article explores the continuing coloniality, that is, long-standing patterns of domination, operating within disease control in Kenya's northeast, whereby punitive encounters with the state loom large. Despite health matters being devolved, top-down implementation from nationally-controlled actors exacerbated local distrust, resulting in contention around the roll-out and of the authorities behind it. This article, drawing on ethnography supplemented by in-depth interviews and Focus Group Discussions over 12 months 2022-2023, centres the experiences of Community Health Volunteers (CHVs) over the ten-day campaign. We adopt a Fanonian lens to interpret our findings, historicizing the contention CHVs faced from their communities, in a region where governmental approaches oscillate between neglect and heavy-handed remedial action. We operationalise Fanon's 'psychoexistential complex', whereby CHVs internalise the conflict between their roles of community representative and state-enforcer, exacerbated by their precarity and invisibility to others. We conclude with a call for CHVs' place to be protected, capacitated and seen within outbreak response.

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United Kingdom WT_ Wellcome Trust

Keywords: Kenya; SDG 10: Reduced inequalities; SDG 16: Peace; SDG 3: Good health and well-being; SDG 6: Clean water and sanitation; Yellow fever; coloniality; community health; justice and strong institutions; vaccinations

0 (Yellow Fever Vaccine)

Date Created: 20250622 Date Completed: 20250624 Latest Revision: 20250805

20260130

PMC12315837

10.1080/17441692.2025.2519659

40544445