In this rich and timely ethnography of women’s health performances in The Gambia, author Bonnie B. McConnell asks “what can music tell us about health, inequality, gender, and power?” (3). To answer, she reads HIV-positive popular singer Fatou’s health-related performances alongside those of kanyeleng, stigmatised groups of women connected by experiences of infertility or child death. Drawing on long-term engagement as a researcher and collaborator, McConnell develops a framework and method for what she terms a “strengths-based approach” to international health projects that begins from the recognition of musical performers’ unique capabilities to transmit knowledge and build social connection.

In its critique of reductive conceptions of African tradition that marginalise women performers and hamper public health efforts, the book highlights a discomfiting resonance between international development and scholarly projects. International development actors reduce tradition to something harmful and backwards even as they harness traditional performance to their goals, while scholars cling to similarly static ideals of authenticity that exclude non-griot musicians and their knowledge, as well as instruments like the kanyeleng’s favoured bidong (plastic jerry can). Yet McConnell shows how kanyeleng’s valuing of flexibility over virtuosity, far from a weakening of tradition, is precisely what makes them such skilled communicators. Reframing neoliberal health discourse, with its focus on individual responsibility, within Mande models of caring relationships, women performers implicate the collective in health practices, invoke social cohesion, and hold leaders accountable. Collectively pieced together from a wide variety of sources and skillfully adapted to particular contexts, kanyeleng knowledge intersects with musical composition, where the collective sounds and movements of performance likewise rely on the combination of individual parts. The implications for health-related performances are clear; to be effective, they must also combine knowledge from multiple sources so that their message resonates with local experience.

McConnell’s nuanced treatment of the relationship between gender, Islam, indigenous spirituality, and tradition challenges Western stereotypes of Muslim women as voiceless and confined to the private sphere. She shows how local associations of both music and emotional expression with femininity open space for women’s voices at the centre of public life. Ironically, health programmes that operate on the assumption of Muslim women’s marginality and silence only succeed thanks to women’s skill in making themselves heard through music. This skill depends on what McConnell terms “performative license,” a concept that emphasises the freedom to hear and be heard rather than to express oneself. As a framework, performative license shifts the focus to communication and reception and, by extension, to the transformative potential of performance and its role in building social cohesion. Embodied performance, then, becomes more important than the lyrical messages that are often at the centre of ostensibly participatory health programmes, whether in the voice of a singer making public her private, embodied experience of HIV, or the participatory combination of ritual knowledge and play that marks kanyeleng performance. Showing how women’s embodied practices reframe power relations at the local, national, and international level, McConnell eschews concepts of passive “empowerment” to instead show how women performers “steal” power that would otherwise be denied them.

McConnell is perhaps uniquely positioned to make these claims. She worked in The Gambia for over thirteen years, first as a Peace Corps volunteer and then as a researcher. Her conclusions emerge from multifaceted collaborative methods across a range of activities, from musical performance––taking lessons, for example, on the bidong––to community outreach. Her style of “performance interviewing” followed norms of kanyeleng women’s communication, moving fluidly between speaking, singing, and dancing. Her interlocutors also produced autoethnographic filmed “fieldnotes” that shifted the direction of her inquiries and later shaped her analysis. McConnell’s close relationships with these women shine through the stories she tells and allow her to address serious issues of health and inequity without reproducing the representational problems that she critiques.

Indeed, throughout the text McConnell paints a picture of particular women as individuals and as conscious members of community, in an earnest account that is at times humorous and at times heartbreaking. Recurring figures and examples lend coherence to the book as a whole, while individual chapters nevertheless stand on their own as excellent resources for teaching. Yet there is a modesty to the text that belies the novelty and significance of its claims. For the ethnomusicologist, this book provides information about an understudied practice, models a method for collaborative ethnography, and makes important contributions to medical and applied ethnomusicology. Moreover, it demonstrates how ethnomusicologists can intervene in global health inequity in concrete ways. McConnell’s incisive critique of international development goes beyond her important gendered reading to offer specific directives for effective health programming, advocating for equitable and sustainable partnerships rather than top-down programming that attempts to use local performers as mouthpieces for neoliberal health messages. She makes a compelling case for how and why ethnomusicology can shape international development projects while holding us accountable for our representational practices. By the end of the book, we are convinced that women’s musical performance in The Gambia does not merely transmit knowledge but, as McConnell shows, translates biomedical information into locally intelligible messages with the potential to enact positive change.