Miriam Waltz

Managing Emerging Cancer Epidemics: Questions of Causation, Toxic Exposure and Health Security

Originally from the Netherlands, Miriam Waltz obtained her MA in Social Anthropology at the University of Cape Town, focusing on medical anthropology and science and technology studies. Her MA thesis followed the trajectory of donated breast milk from mostly middle-class donors to babies in a public hospital in Cape Town as it crossed geographical and social boundaries.



 Historically global public health initiatives in the African context have been mainly concerned with infectious diseases. However, recently there has been a rise in incidence of non-communicable diseases, and subsequently a turn in global health. A major threat to health security in Africa is the rising cancer epidemic: approximately 70% of deaths from cancer now occur in low- and middle-income countries (WHO 2018). An important theme within new approaches to cancer is the role of environmental toxicants in causation. Pesticides in particular have been a source of controversy in recent years that have led to court cases in the US, tightening regulations in the EU, and increasing public concern in Kenya, where a long legacy of intensive agriculture paired with food insecurity creates potential for widespread harmful exposure.

The Kenyan government has recognized the importance of addressing rising cancer rates and launched the Kenya National Cancer Control Strategy 2017-2022. This strategy highlights that increased exposure to environmental carcinogens is one of the four key risk factors fueling the rising cancer burden (Ministry of Health 2017). Kenya provides an important study site because of its developing national response to the rising cancer burden, and in particular for recognizing the potential exposure to multiple forms of environmental pollution in relation to this. The effects that questions of causation have on practices of protection and prevention among agricultural workers, health professionals, researcher and policymakers will be the focus of this research project.


I aim to explore the management of the emerging cancer epidemic in Kenya, with a particular focus on how the question of causation is understood at different nodes in health systems and infrastructures of protection, and how these interact with environmental pollution and social structures, shaping human security. I will engage ethnographically with policy makers, health professionals, patients and families, as well as populations that are at high risk of toxic exposure to understand the processes and responses set in motion by understandings of causation on a collective, institutional and individual level.


The research will contribute to knowledge about changing and emerging epidemics in the East African context, and their impact on overlapping aspects of human security, such as health, environment, infrastructure and livelihoods. The research includes a secondment period at the Kenya Medical Research Institute (KEMRI).