The proposed dissertation research documents the flow of sickle cell disease knowledge between Paris and Dakar. The conditions and constraints of sickle cell anemia in Senegal have prompted French-trained physicians at the Hopital Albert Royer in the Fann area of Dakar to question the universality of sickle cell patient care and treatment protocols as these have been established in the United States and France. Sickle cell disease in Atlantic Africa is known to correspond with a specific genetic variant (the Senegalese haplotype) which may be responsible for a less severe form of this disease. This project takes seriously a dialectic between culture and biology, by tracing the ways in which biological difference, geography and cultural values contribute to the modification of scientific and medical knowledge. Through interpretive social science methods based on interviews and participant-observation, the investigator will analyze the dynamic processes that allow for rethinking approaches to sickle cell care in Senegal and elsewhere.