For international experts health is a comprehensive concept closely linked to bodily material
spiritual and social well-being. But what does health mean to women living in a poor
neighborhood of an African city? Women in Dar es Salaam see health as primarily related to
livelihood hygiene and care. To stay healthy one has to fulfill basic needs for food water
and shelter to keep the body and home clean and to take good care of the family. Since the
state and newly privatized services hardly reach them and husbands often fail in their role as
breadwinners women bear a growing burden in daily health practice. They become increasingly
vulnerable unless they manage to create a new balance by improving their knowledge becoming
economically more independent and raising support within the household in social networks and
organizations. By shifting the focus from illness to local meanings of health and vulnerability
anthropology can make a unique contribution to the rapidly expanding field of urban health
research. Such an actor-centered approach provides fascinating insights and fosters innovative
theoretical debates for both scholars and practitioners. With regard to medical anthropology
this study opens new lines of inquiry which may eventually lead to an anthropology of health.
