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Toxic layering through three disciplinary lenses: childhood poisoning and street pesticide use in Cape Town, South Africa
  1. Alison Swartz1,
  2. Susan Levine2,
  3. Hanna-Andrea Rother3,
  4. Fritha Langerman4
  1. 1 Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
  2. 2 School of African and Gender Studies, Anthropology and Linguistics, University of Cape Town, Cape Town, South Africa
  3. 3 Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
  4. 4 Michaelis School of Fine Art, University of Cape Town, Cape Town, South Africa
  1. Correspondence to Dr Alison Swartz, School of Public Health and Family Medicine, University of Cape Town 7925, South Africa; alison.swartz{at}


This article focuses on the devastating hidden perils of agricultural pesticides repurposed by informal sellers in urban South African townships to kill rats and other unwanted pests. Drawing on collaborative research techniques, we investigate the causal relationship between child poisoning episodes and the household use of illegal street pesticides. Such pesticides are used to safeguard homes from pests in an attempt to protect children from the harmful consequences of rodent bites and vectorborne diseases. Here, we consider the social injustice and economic inequality of episodes of child pesticide poisoning in the Western Cape from three disciplinary perspectives: public health, medical anthropology and fine art. We ultimately seek to demonstrate the complex relationship between the political economy of sanitation, waste removal and insecure housing, and the proliferation of rodents and other pests in urban townships. As a contribution to the medical humanities, the paper leans into different disciplines to highlight the toxic layering at play in a child pesticide poisoning event. The public health perspective focuses on the circulation of illegal street pesticides, the anthropologists focus on the experiences of the children and caregivers who are victims of poisoning, and the fine artist centres the rat within a broader environmental context. While non-toxic methods to eliminate rats and household pests are critical, longer term structural changes, through environmental and human rights activism, are necessary to ameliorate the suffering caused by poisoning. The medical and health humanities is well poised to highlight creative ways to draw public attention to these challenges, as well as to bridge the divide between science and the humanities through collaborative research efforts. With this paper we set the stage for discussing and balancing perspectives when addressing pest control in poor urban communities.

  • public health
  • medical humanities
  • child health
  • art and medicine

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  • Contributors HAR conceived the study and submitted the proposal for funding and ethics approval. AS collected child poisoning narratives for her Honours degree in Social Anthropology, with SL as primary supervisor and HAR co-supervisor. HAR, AS and SL analysed the qualitative data collected in this study. HAR designed and analysed quantitative elements of the study that have been published elsewhere. AS, SL and HAR all contributed to the developments of early drafts of the article. SL took the lead on developing the medical humanities approach, with critical amendments made to subsequent drafts by AS and HAR. AS took the lead on pulling together this version of the article. FL provided the artwork for this article as a way to offset the narrative in consultation with all authors. All authors approve the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval University of Cape Town Health Sciences Ethics Review Board (HREC 222/2007).

  • Provenance and peer review Not commissioned; externally peer reviewed.