Albinism is a global public health issue but it assumes a peculiar nature in the African continent due, in part, to the social stigma faced by persons with albinism (PWAs) in Africa. I argue that there are two essential reasons for this precarious situation. First, in the African consciousness, albinism is an alterity or otherness. The PWA in Africa is not merely a physical other but also an ontological other in the African community of beings, which provides a hermeneutic for the stigmatising separateness or difference of the PWA. The second reason hinges on a distinction drawn by Jürgen Habermas between the ethical point of view and the moral point of view. While the former consists of the ethos, customs, or idea of the good shared by a group of persons with a shared tradition or way of life, the latter consists of what is good for all and transcends particular traditions or ways of life. Consequently, the African ethical point of view, the ethics of solidarity, justifies within the African worldview the established alterity and, by implication, stigmatization of PWAs. On this view, actions that promote harmony and prevent discord and disequilibrium among accepted beings in the African community are permissible. I further show that unless there is a change in the physical and ontological conception of PWAs and a leap from the ethical point of view to the moral point of view, the negative attitudes toward PWAs will not change. The leap to the moral point of view does not suggest an abandonment of the ethical point of view but only recommends that the two meet halfway in respect for universally accepted norms of human actions. To achieve this, I will show that much needs to be done in the areas of policy formulation, law, health care services, and education.

In this study, I explore the challenges that ideological hegemonies of personhood imbibed by nurses and other healthcare workers could pose for the nursing profession, particularly in terms of inhibiting the acknowledgment of difference. Dominant or hegemonic conceptions of personhood in particular spaces often consist of self-contained ideas and essentialist ontologies and normativity of what it means to be a person, lack of which results in the denial of personhood and the othering as non-person or sub-person. The other as the residue of such selfcontained notions of personhood is most often denied the quality of care that the one who fits within such conceptions enjoy. For nurses and other healthcare workers to overcome such exclusionary tendencies in healthcare, they must overcome hegemonies and ideological dominance and be more open to alternative viewpoints and theories of personhood. I develop these lines of thought by focusing on the rich ideological traditions of Continental and African philosophies showing how exclusion takes place within these traditions based on conceptions of personhood and how such exclusion on the basis of difference impacts negatively on healthcare. I conclude by highlighting the need to go beyond hegemonic philosophies of personhood by decolonizing and demasculinizing healthcare, thereby allowing difference to flourish in an ecology of medical knowledge.

In many parts of sub-Saharan Africa, mothers impacted by the genetic condition of albinism, whether as mothers of children with albinism or themselves with albinism, are disproportionately impacted by a constellation of health-related stigma, social determinants of health (SDH), and human rights violations. In a critical ethnographic study in Tanzania, we engaged with the voices of mothers impacted by albinism and key stakeholders to elucidate experiences of stigma. Their narratives revealed internalized subjective stigma, social stigma such as being ostracized by family and community, and structural stigma on account of lack of access to SDH. An analysis of health systems as SDH revealed stigmatizing attitudes and behaviours of healthcare providers, especially at the time of birth; a lack of access to timely quality health services, in particular skin and eye care; and a lack of health-related education about the cause and care of albinism. Gender inequality as another SDH featured prominently as an amplifier of stigma. The findings pose implications for research, policy, and practice. A concrete avenue to de-stigmatization of mothers impacted by albinism exists by the application of principles of human rights, particularly equality and non-discrimination; contextual analysis of cultural dynamics including relevant ontology; meaningful participation of rights-claimants, such as peer groups of mothers; and accountability of governments and their obligation to ensure access to health information as a key social determinant of the right to health.

Chapter Three The Epistemology of Albinism in African Traditions Abstract This chapter explores the epistemic injustice that has been done to persons with albinism in African societies through deeply entrenched theories of knowledge and processes of knowing in African thought. It begins with an attempt to construct an African theory of knowledge by theorizing three interrelated levels on which an African can claim to know anything: (i.) knowledge understood as first-hand information; (ii.) knowing consistency with established beliefs ; and (iii.) knowledge as implying 'we know that'. It then proceeds to an examination of the African processes of knowing or modes of knowledge acquisition. The chapter also examines factors responsible for the persistence of false and harmful beliefs about albinism in Africa today and the role epistemic ignorance play in this process.The ideas about the coming-to-be and the nature of the being of persons with albinism clearly indicates that African indigenous communities possess a body of knowledge and truth claims about such persons as queer beings that have been institutionalized into society and preserved by social structures that influence the way communities deal with persons with albinism, as well as how such persons view themselves within such particular worlds. This immediately raises some epistemological questions about such knowledge claims, how they are acquired, justified and preserved in human society. What is the basis of human knowledge in African traditional communities, or what does it mean for an African to claim to know in an African context and, in this case, to know certain things about albinism and be sure that her knowledge of such a being is true? How does an African explain the reliability of her knowledge claims about albinism? How does she explain the nexus, for instance, between the amputated limb of a person with albinism and protection from bad luck or creation of wealth?