This article examines how Rwandan patients understand and represent cancer, as well as how state actors articulate the agenda of public oncology and related expectations of citizens. Patients view cancer and infection as co-existent and processually intertwined. This elides with the reality of epidemiology on the ground, as the local burden of disease encompasses both infectious and noncommunicable diseases. Further, patients still consider the efficacy of occult acts in causing tumors, particularly in the face of a disease marked by etiological uncertainty in the biomedical realm, and frequent resistance to treatment. At the same time, both policy makers and clinicians servicing public oncology expect citizens to quickly relinquish any beliefs in the occult and fully embrace a biomedical value system. Beyond the fact that this project cannot be fulfilled, its articulation only limits the ability to envision a more capacious framing of oncology which acknowledges both the limits of treatment, and the diverse ways in which patients suffering from cancer make meaning in the face of grave illness.

中文翻译：

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多能轨迹：卢旺达的公共肿瘤学

本文探讨了卢旺达患者如何理解和代表癌症，以及国家行为者如何阐明公共肿瘤学议程和公民的相关期望。患者将癌症和感染视为共存并在过程中交织在一起。这与实地流行病学的现实相悖，因为当地的疾病负担包括传染性疾病和非传染性疾病。此外，患者仍然会考虑隐匿行为在引起肿瘤方面的功效，特别是在面临以生物医学领域病因学不确定性为特征的疾病以及对治疗的频繁抵抗时。与此同时，为公共肿瘤学提供服务的政策制定者和临床医生都希望公民能够迅速放弃对神秘学的任何信仰，并完全接受生物医学价值体系。