The main purpose of this book is to illustrate that medical research centers and their histories are about much more than the knowledge they produce or the bodies they heal. Their capacity to restructure space and facilitate interpersonal relationships create diffuse meanings for the people who have interacted with them, making them loci of community, symbols of societal aspirations, figurative repositories of memories, and literal repositories of discarded junk, among many other things. As such, when the science stops (as when a center closes or ceases to function) these other traces remain, continuing to shape local worlds and worldviews in subtle ways.

This book focuses on five sites of medical research in twentieth-century sub-Saharan Africa whose roles have either massively diminished or completely transformed over time (Uzuakoli leprosarium in Nigeria; the hospital complex at Ayos in Cameroon; the Amani Hill Research Station in Tanzania; the demographic observation program at Niakhar in Senegal; and the current global health city of Kisumu in Kenya). The authors of this volume have produced something of an ethnography of modern ruins, emphasizing the complex social and cultural meanings and memories that these sites produce in their respective local areas, often long after the original aura of scientific prestige has faded.

This part of the review is where one would normally expect a detailed breakdown of the content of the book. However, this book does not really lend itself to a content summary due to its unconventional structure and presentation. While there are five chapters – one for each of the medical centers described above – at no point do the authors attempt to tell a story or make a grand argument either within or across chapters. Rather, the book tells snippets and fragments of hundreds of stories, presented in the form of photographs, partial transcripts of recorded conversations, excerpts from field notes, brief biographical sketches, and even Samuel Beckett quotations. The book is organized more like a coffee table book, text and image are juxtaposed and related to one another, but they are not robustly integrated or analysed. The musical compositions of a patient at Uzuakoli, the dispersed bricks of a demolished hospital in Ayos, and notes about late night excursions with treasure hunters seeking rumored riches buried under abandoned buildings at Amani are all carefully curated and imaginatively presented. They are also remnants of twentieth-century dreams of modernization gone, but not completely forgotten. Contact with these traces ‘accumulates but does not cohere’ as Nancy Rose Hunt writes in her introduction to the volume. The resulting account is not a representation of a past or present condition, but a diary of encounters, which is presented directly to the reader (22).

This approach produces mixed results. On the one hand, the creativity involved in organizing and presenting this multiplicity of traces is definitely impressive. Some of the images are gorgeous and some of the testimonies quite moving. However, on the other hand, the reader is left wondering what, if anything, all this evidence really means. Those of us with experience conducting field or archival work in African settings are already no doubt acquainted with the existence of traces like these and, hopefully, cognizant of the ethical and methodological complexities created by fragments and absences: there are no real surprises here for specialists. And, ultimately, there is very little information about the medical research centers and their histories that are featured in the book, so there is not much new material for historians of science or medical anthropologists. It seems that ultimately the ideal audience for this book are non-practitioners who might find such an object lesson in the complexities of fieldwork unique and fascinating. But this goal does not seem to have been the intent of the volume, as the little contextual material that it provides is riddled with jargon and academic cross-references, which effectively mystify and obscure the most mundane aspects of everyday experiences in the field. The team that visited Ayos sums up the overall impression that the book produces: ‘We sighed a lot during this fieldwork, impatient with our own incapacity to explain what we were interested in’ (83).

The uncertainties, anxieties, and incompleteness that characterize this book are not necessarily marks against it, however. To the contrary, they reinforce the affective experiences of the people whose stories populate it. What can we make of projects that do not turn out the way they were intended – scientific or anthropological? What value can those projects have and produce, despite their disappointments? Surely our work affects us regardless of its outcomes, and partial outcomes are more the norm than the exception. Fragments and traces abound, and we usually do not know how to relate them in our myopic quest to make intellectual order. Just because the evidence and narration does not cohere does not mean that they do not matter. Ultimately, this book forces us to question why we tend to see the incoherent as unimportant and the non-linear as lacking in meaning. It is an existential trek for any Africanist willing to take the journey.