By Edward C. Green
Book review by Curtis Abraham
In his newly published memoir, On the Fringe: Confessions of a Maverick Anthropologist, the American medical anthropologist Edward Crocker Green has given his readers a valuable, candid, and somewhat troubling narrative that is also filled with warmth, conviction, naivety, dry humor, and some remorse.
Green’s personal and professional experiences are complex, controversial, and poignant. He spent the better part of over three decades as a globetrotting applied medical anthropologist and public health consultant to the developing world. In Africa, he conferred extensively with the continent’s traditional healers (the region’s primary healthcare providers) in an effort to bring about collaboration between them, Western doctors, and health officials with the aim of creating public health programs.
Green would also establish public health programs in various parts of the developing world that dealt with global health challenges such as HIV/AIDS, primary health care, family planning, child nutrition, water and sanitation, and maternal-child health (a “diarrhea man” in Bangladesh) that led to appointments at the Harvard School of Public Health and John Hopkins University in the US.
For his efforts Green became a consultant for an American president’s global health program, a member of the Presidential Advisory Council on HIV/AIDS
among other accolades, not to mention picking up the occasional award from an African head of state
And yet, for all his achievements and success, which includes publishing nine books chronicling his time working in international health and its challenges, there hung a low, dark cloud overhead. Right from the outset of the book, Green is candid about his anxiety, self-doubt, and depression (on consultancies abroad and fearing the paralyzing grip of imposter syndrome, Green often had with him an emergency valium in case of a serious panic attack). He also suffered from Accelerated Aging Awareness Anxiety and Agoraphobia when traveling, abroad. As if that weren’t enough, there was also parental conflict, particularly with his controlling mother that contributed to him becoming a hoodlum and hippie.
His ancestors were wealthy and influential New Englanders. In other words, “Boston Brahmins”, architects of American colonial experience that included Governor John Winthrop of Massachusetts Bay Colony, an influential personality in the founding of the second major settlement in New England after Plymouth Colony ( (Winthrop reportedly coined the phrase “city upon a hill” as a Puritan blueprint for further New England colonial development). Samuel Seabury, America’s first Episcopal Bishop, Loyalist and slave-owner was also kinfolk.
As a young child, he describes his loneliness at boarding school and felt a deep yearning for his father’s presence. But it was busy times for Marshall Green in the Foreign Service, which he had joined after leaving the Navy at the end of the Second World War. There were a series of appointments at the US Embassy in Auckland, New Zealand, then as the chief assistant to US Secretary of State John Foster Dulles.
In 1972, while serving as Assistant Secretary of State for East Asian and Pacific Affairs in Richard M. Nixon’s administration, undoubtedly the pinnacle of his diplomatic career, he accompanied the Watergate president on his landmark trip to China.
But like some children of privileged parents with high expectations for their kids, these pressures mounted on Green the younger to the point where rebellion was almost inevitable.
The early years of his student life is a literal joyride of pre-adolescent mischief-making-like episodes of Hal Roach’s “Our Gang” (“Little Rascals”) comedies. Unlike the Little Rascals capers, however, these activities were darker and filled with existential angst.
As a teenager, his life spiraled into juvenile delinquency. Green co-founded a street gang, complete with black leather jackets, switchblades, and a pompadour à la Elvis. He quietly blackmailed the principal of a US military school in Seoul, South Korea to promote him from freshman to junior. He challenged a teacher to a fistfight in class: “…why don’t you and I just step outside.” He smoked cigarettes and drank copious amounts of liquor.
But the one incident that shaped his youth and, to a certain extent, helped define the rest of his life was a broken promise made by his mother, Lispenard Crocker (Lisa) Green, his reaction to that broken promise, a false accusation of troublemaking at school, and having a “chronic, negative attitude” led to his expulsion from Groton, a prestigious New England boarding school that was his father’s alma mater.
His mother was devastated. She told him that not only was he a failure, but would always be so.
In his later teens, however, Green felt a growing desire for “conventional respectability and achievement”. At this time he had a clear-sighted sense of justice by the unfairness of American institutions such as the draft system during the Vietnam War, and the notion that a life worth living involves what Buddhists describe as the joyous participation in the sorrows of the world.
The fact that his chapters on ethnographic field research on the Matawai, a South American maroon community living in the Amazon rainforest of Surinam (Dutch Guiana), for his doctorate are lively, vivid and a joy to read, is a testament to the reality that besides some early hiccups, his integration into the village life of these New World Africans was, smooth, pleasant and even heartwarming (not all ethnographic fieldwork begin with such good fortune. Napoleon A. Chagnon field study of the Yanomami and Colin M. Turnbull among the Ik mountain people are two of the better known and controversial examples in the discipline).
But even when life was blissful among the Matawai, it wasn’t enough to save Green’s first marriage. He loved his wife, Shannon, and had traveled with her and their young toddler son Tim to the South American jungle nation (Tim was given the name of Piki Dungidungi, a small fish that swims upstream in the Matawai language)
(Doing ethnographic fieldwork with one’s spouse is not unheard of in the field of ethnography. For instance, renowned British anthropologist David Maybury Lewis and his wife Pia were together in Brazil during his 1953 study of the Xavante, an indigenous community living remotely on the savannah of the Mato Grosso. Pia was also a co-founder of Cultural Survival, an NGO that, among other aims, defends the human rights of indigenous peoples.
Shannon contracted typhoid fever after drinking untreated river water and had to be medically evacuated back to Washington, DC. Although she grudgingly returned to Matawai-land, the writing was on the wall and they soon divorced (Green later re-married and a half century later his love for Suzie endures)
It was heartening to read how in a relatively short time period (after a brief spell digging ditches as a day laborer), Green transformed himself from a valium-popping, insecure basket case into a self-confident “career coach” with sufficient USAID experience behind him to be able to give free advice to young anthropologists who wanted to transition into the sphere of global health or international development work, but lacked practical experience.
Nevertheless, the reputation of being a rabble-rouser followed him into his adult professional career as an applied medical anthropologist often by speaking truth to power ("instead of teaching introductory anthropology for the rest of my life, I could be saving lives by applying the useful things anthropology had to offer”). None more so than with his HIV/AIDS prevention work in sub-Saharan Africa during the 1990s. Together with a handful of epidemiologists and biomedical researchers, Green advocated for behavior change as a more effective method of HIV prevention rather than condoms or testing strategies. It was an indigenous lesson he learned from Uganda’s early approach to fighting HIV infection.
The landlocked East African nation not only had the limited financial resources of a country emerging from years of civil war and decades of political instability, but also one of the highest HIV/AIDS infection rates on the continent. The leadership in Uganda promoted sexual behavior change (i.e. fidelity) as its strategy for combating the deadly virus. Expectedly, it was ignored or overlooked by some Western observers who, among other criticisms and misgivings, stereotypically believed that Africans were set in their sexual ways.
But for over a decade during 1992 to 2003, there was a two-thirds decline in Uganda’s HIV prevalence rate. Green’s outspokenness on the ineffectiveness of policies particularly the use of condoms in fighting the deadly virus would have a major impact on his career. Nevertheless, he would be vindicated in a number of later studies, surveys, and at least one popular book on Uganda’s “invisible cure”.
The author takes the reader along on his various assignments around the world including the West Bank/Gaza Strip, Ukraine, Bangladesh, Swaziland, Nigeria, China, Tanzania, South Africa, and Mozambique, among many others with brief, but illuminating, sketches of life in exotic, but sadly many impoverished locations, and introducing us to insightful local colleagues as well as the ins and outs of USAID, UNICEF, or European Union (EU/EC)-backed consultancies, for example, and how he as a medical anthropologist approached a particular public health challenge in a specific location.
Green is quick to point out and praise the genius of Indigenous Knowledge (IK) in local health matters (African traditional healers, for instance, had long noticed the link between HIV infection, male circumcision, and Sexual Transmitted Infections before Western science could prove it), and by extension, emphasizing how bottom-up, grass-roots approaches have been proven more effective than the paternalistic, top-down Western approach that has become somewhat archaic over the past generation in the international development circles (when Green pitched the idea of further research on male circumcision as a preventative factor in contracting HIV to the head of USAID's AIDS Program in Washington DC, a gay activist from San Francisco, he was immediately rebuffed despite what traditional healers were observing in Swaziland and South Africa).
Not simply relying on numbers and statistics, Green employed the use of qualitative research into designing public health programs. It’s a method used by ethnographers whereby data is collected through interviews and observations, which are then used to draw conclusions about an individual’s social reality, including understanding their behavior, attitudes, and motivations thereby allowing an outsider to peer into the soul of society( the fact that Swazi [Eswatini] aristocrats spend vast sums on medicine to counter any witchcraft or sorcery that would rob them of their wealth and status in a society that has strong egalitarian beliefs tells you that, despite their social standing, they too are not immune to malevolent forces).
The book contains many poignant passages where Green interacts with local colleagues and locals generally during his consultancies abroad.
“One little girl with large, soulful eyes followed me for the entire walk around Old Dhaka. Remembering how I was mobbed by scores of beggar kids some years earlier in Delhi, I waited until we had climbed back into rickshaws before slipping this girl a sizable banknote. She stuffed it in her torn dress and proceeded to run alongside my rickshaw, which quickly picked up speed as we maneuvered into heavy traffic. I tried to shoo her away because she was now clinging to the back of the rickshaw, and her thin legs were running faster than they could have run on their own power. I was terrified she’d be run over when she finally had to let go. Just when I was trying to get my driver to pull over, her strength seemed to give out and she somehow stumbled back to the sidewalk unharmed. Her eyes were still on mine as she was swallowed up by the crowd.”
In his downtime, at home and abroad (particularly in the company of Yankee ex-pats during festive occasions), there was always music, which provided much solace. He had been a guitarist since his school days in Korea with The Silvertones. Green became a multi-instrumentalist and could also play the fiddle, which came in handy when playing traditional country music or the folk music of the Appalachians, a mountain range in the east and northeast US. The field of ethnomusicology was open to him via a post-doctoral opportunity at UCLA, but apart from teaching, there were few opportunities for making a living from it.
The memoir is filled with Green’s deadpan humor (“There was a curious poster on the USAID office walls: IF YOU CATCH FIRE, FALL AND ROLL! Maybe
this job was more dangerous than they were letting on.”; and “One thing I have noticed about African nations that follow the socialist path: They always lock the bathrooms in government buildings and make you ask for the keys, which are always hidden away…Perhaps it’s a control thing. Citizens with sphincters stretched tight as a bowstring are less likely to get uppity, democratic, antiauthoritarian ideas.”
He also describes metaphysical or paranormal episodes (i.e. out-of-body experiences) in his life. In fact, in 1996, Green incorporated these beliefs into his work. As a team-building exercise, he conducted a focus group discussion on the paranormal in northern Mozambique. Green discovered that every single person has had a supernatural experience.
If there are any shortcomings in the book it's that one would have liked more of the author’s insights, however brief, on how applied anthropology can help tackle some of America’s most urgent social malaise such as the health disparities between whites and minorities, vaccine hesitancy, illegal narcotics, and the opioid crisis, abortion as well as other non-public health challenges. But perhaps the author felt that time was of the essence and could not explore these other American public health topics given the fact that he was diagnosed with cancer of the neck and head; another uniquely American public health challenge.
Green’s memoir is dedicated to the Matawai (years later, three Matawais were awarded a Smithsonian grant to visit Washington DC to study Green's archives, which were given to the National Anthropological Archives, at the Smithsonian Museum.) From this runaway slave community who opted for life in the rainforest rather than being whipped, chained, or worse during the 17th and 18th centuries (escaping oppression and rebelling as Green had done as a youngster from Groton) he learned the joy of fieldwork, that racism was unnatural, and that a people or an individual can rise above socio-historical injustices, or crippling psychological/psychosocial malaise and be greater beings than the suffering they have endured. Green is living proof.
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