Decolonising 'man', resituating pandemic: an intervention in the pathogenesis of colonial capitalism.

This paper brings together fifth-wave public health theory and a decolonised approach to the human informed by the Caribbean thinker, Sylvia Wynter, and the primary exponent of African Humanism, Es'kia Mpahlele. Sub-Saharan indigenous ways of thinking the human as co-constitutive in a subject we might call human-animal-'environment', in conjunction with the subcontinent's experiences of colonial damage in disease 'prevention' and 'treatment', demonstrate the lack of genuine engagement with Indigenous wisdom in Western medical practice.The paper offers a decolonial reading of pandemic history, focused primarily on the human immunodefiency virus (HIV), the severe acute respiratory syndrome of 2003 caused by the SARS Covid 1 virus (SARS-CoV1) and COVID-19, caused by the SARS COVID 2 virus (SARS-CoV2) to demonstrate the importance of the co-constitutive subject in understanding the genesis of these pandemics as driven by colonial-capitalism. I emphasise that prevention will indeed take the kinds of massive changes proposed by fifth-wave public health theory. However, I differ from the proponents of that theory in an insistence that the new kind of thinking of the human Hanlon et al call for, has already been conceived: just not within the confines of the normative human of Western culture.I illustrate that Western Global Health approaches remain constitutionally 'deaf' to approaches that, although the West may not understand this to be the case, arise from fundamentally different-and extra-anthropocentric-notions of the human. In this context, Man as Wynter names Him is a subject ripe for decolonisation, rather than a premier site of capitalist development, including that of healthcare provision.Recognising that most of us are not individually able to change the structural violence of the colonial capitalist system in which Global Health practices are embedded, I conclude with implications drawn from my argument for quotidian practices that enable healthcare providers see their actions within a harm reduction paradigm, in the context of communities experiencing intergenerational impoverishment consequent on colonial violence.

Distress, desperation and despair: anxiety, depression and suicidality among rural South African youth.

Common mental disorders (CMDs) affect millions of people worldwide and impose a high cost to individuals and society. Youth are disproportionately affected, as has also been confirmed in South Africa. Mental disorders and substance use disorders often occur as concurrent disorders. Although youth in rural South Africa grow up in difficult social and economic conditions, the study of mental disorders in South Africa has focussed primarily on urban populations. One such rural area in South Africa is the Harry Gwala District, where rates of interpersonal violence and self-inflicted injuries among 15-24-year-old men, are extraordinarily high. Suicide is an important proxy measure of severe emotional distress, predominantly depression and hopelessness. This study reports on rates of fatal self-harm among 15-24-year-old men in the Harry Gwala District. We determined the rates and severity of CMDs and their correlates among 355 young males ranging in age from 14 to 24 years in the Harry Gwala District community. High rates of depression, anxiety, hopelessness and worthlessness were reported. One in four of the young men and boys reported current suicidal thoughts associated with depression, anxiety, feelings of worthlessness and binge drinking. Reports of alcohol use were high, as were those of daily cannabis use. Our findings show high rates of CMDs and alcohol use, and highlight the impact of collective dysphoria on the mental well-being of rural youth in South Africa, who are likely coping through drug and alcohol use.