LAUSR

rhetoric focused on injustices within South Africa. This political project could prove complex, not only because of the deficiencies in medical care in ANC facilities, but because the organization’s own ideology remained unsettled. When the National Party pursued a coercive birth control campaign among black South Africans using Depo Provera, the ANC called the drug a tool of “genocide.” Tshabalala attempted to convince leadership to withdraw from the International Planned Parenthood Federation, even as other ANC activists sought to foster relationships with the group. In practice, however, the Health Department discouraged pregnancies and, as Armstrong recounts, its staff were even accused of coercing female members into abortions. Ultimately, it is difficult to capture the patient perspective through official correspondence. This is a challenge familiar to many working in colonial and postcolonial African archives. Armstrong works to recover these experiences in a chapter on mental health, which highlights the challenges of providing care to traumatized patients in environments marked by distrust. She details how psychiatrists were limited in the questions they could ask, and the traumas they could probe, for fear of divulging military secrets. The general tenor of this book, like many on health care in southern Africa during the latter half of the twentieth century, is disappointment. The history of the ANC’s Health Department is, to a large extent, one of designs thwarted, of aims unachieved. The ANC may have portrayed itself as a “government-in-waiting,” but it practiced guerrilla medicine for decades. In this frustration of lofty aims, the Health Department serves as a fitting precursor to the post-apartheid health sector, where the rhetoric of justice has long outrun practical achievements. As Armstrong admits, the story remains far from complete. But her work, well worth the read, is part of an essential endeavor to detail South African health care in the liminal space between unyielding oppression and promised liberation.