This article examines a development initiative spearheaded by the members of a transnational diaspora – the creation of a medical hospital in the holy city of Touba in central Senegal. Although the construction of the hospital is decidedly a philanthropic project, Hôpital Matlaboul Fawzaini is better understood as part of the larger place-making project of the Muridiyya and the pursuit of symbolic capital by a particular Mouride dahira. The dahira's project illuminates important processes of forging global connections and transnational localities, and underscores the importance of understanding the complex motivations behind diaspora development. The hospital's history reveals the delicate negotiations between state actors and diaspora organizations, and the complexities of public–private partnerships for development. In a reversal of state withdrawal in the neo-liberal era, a diaspora association was able to wrest new financial commitments from the state by completing a large infrastructure project. Despite this success, we argue that these kinds of projects, which are by nature uneven and sporadic, reflect particular historical conjunctures and do not offer a panacea for the failure of state-led development.

While many parts of the world continue to experience a set of transformations commonly glossed as globalization, much of the African continent occupies a tenuous position in this new economic landscape. Many urban and rural regions suffer from the neglect of diminished states that no longer have the means or the mandate to address escalating poverty, inadequate public services, or the dearth of livelihoods. In response to worsening conditions, many Africans are emigrating to larger cities, different countries, and new continents in search of social and material opportunities that they lack at home.

Once thought of as a straightforward path from departure to assimilation, migration is now understood as a process in which migrants establish social formations within a transnational space as they continue to participate in cultural, economic, and political life in their home and host countries.1 The establishment of African diaspora communities throughout Europe and North America has fuelled new kinds of circulation of people, goods, and values.2 In spite of the sociological richness and complexity of these diasporas, one dimension in particular has caught the imagination of the international development community – the large and increasing volume of remittances that migrants send home.

Globally, the value of migrant remittances is greater than official development assistance and foreign direct investment; recorded remittances doubled between 2002 and 2007.3 African migrants have participated in this growing trend. Although North Africa receives the greatest volume of remittances, in 2007 sub-Saharan Africa received US $10.8 billion. The top five receivers were Nigeria, Kenya, Sudan, Senegal, and Uganda.4 In 2007 alone Senegal received nearly US$1 billion from its diaspora.5

As remittances and diaspora projects now overshadow traditional forms of development aid, scholars and development professionals have begun to assess the impact of remittances and the social forces behind them. Some question whether transfers promote equity and sustainable development or aggravate inequity.6 Others suggest that diasporas function as part of the unfolding of global capitalism that has usurped state-led ‘development’.7 In a fascinating example of cultural innovation, Bob-Milliar describes Akan communities pursuing development through granting chieftaincy to diasporic Africans.8 Grillo and Riccio highlight the potential of translocal development in which non-state entities in the North and South, including migrant associations, collaborate on projects.9 Still others argue that diaspora initiatives might transform the very notion of development itself, and urge caution when attempting to incorporate migrant efforts into normative understandings of development.10 In spite of these questions, enthusiasm for ‘diaspora development’ remains high. Remittances have not yet attained the status of magic bullet, but they are seen as a ‘promising source of resources for attaining the Millennium Development Goals’ and as a means to ‘leverage funds for development’.11

In this article we seek to move beyond the current enthusiasm for diaspora development to examine its numerous paradoxes. We do so through an analysis of Hôpital Matlaboul Fawzaini, an initiative spearheaded by a Mouride dahira (a mutual aid group of Mouride disciples) whose members live primarily in North America and Western Europe. Although the hospital project is decidedly philanthropic, we contend that Hôpital Matlaboul Fawzaini is better understood as part of the larger ‘place-making project’ of the Muridiyya and the pursuit of symbolic capital by an increasingly powerful dahira.12 The notion of place making draws attention to the processes by which Touba's material transformation (physical expansion, demographic growth, creation of ritual spaces) becomes infused with religious significance. The dahira's insistence on achieving Shaikh Amadou Bamba's holy vision of Touba first and foremost, and meeting the needs of its residents second, underscores the importance of understanding the complex and multiple motivations behind diaspora development.

By building Hôpital Matlaboul Fawzaini, the Mouride dahira entered the realm of large capital projects the likes of which typically fall under the mandate of the developmentalist state. Nonetheless, we argue that this project represents a distinct form of development, and one that is not easily incorporated into state schemas for urban development or public health.13 Equally important, the hospital's history reveals the delicate and often contentious negotiations between state and non-state actors and diaspora organizations. The hospital project's complicated and costly road to success highlights the pitfalls of the neo-liberal age in which ‘development’ has been relegated to actors in the private sphere who attempt to close the gap between needy populations and an ineffective state.14

Our analysis of how dahira are positioning themselves as development players remaking the Mouride homeland also offers a new dimension to scholarship on the Muridiyya.15 The Mourides were once known as a Sufi order comprised largely of rural peasants who laboured on their own fields and in the fields of their religious leaders.16 Over the past 30 years they have transformed into an increasingly urban, transnational tariqa (Sufi order) whose followers have come to rely on local, national, and international commerce as their primary economic strategy. Touba, the religious capital of the Mourides, founded by Sheikh Amadou Bamba Mbakke in the nineteenth century, is now Senegal's second largest city, with close to one million inhabitants.

Recent research on the Mourides examines their migration across Africa, Europe, and North America, how they reproduce their institutional structures in new social settings, and how they have invented new circuits of accumulation.17 As a project of the Mouride disapora, the hospital illuminates the processes through which Mouride emigrants forge global connections and capitalize on the opportunities afforded by their transnational social networks. The dahira's profound commitment to building the holy city of Touba, its ability to persevere in the face of significant technical and financial obstacles, and its internal crisis of leadership around the time of the hospital's completion are crucial to understanding the Muridiyya's resilience, dynamism, and adaptability.

‘Money and know-how are not the same’: the story of Hôpital Matlaboul Fawzaini

Hôpital Matlaboul Fawzaini is the first privately funded hospital ever built in Senegal by a Muslim organization, the dahira of the same name. Mouride dahira have been a familiar feature in Senegal for the past several generations. Dahira initially helped ease the sense of dislocation of newly arrived Mouride dwellers in Senegalese cities.18Dahira in Africa, Europe, and North America form networks that facilitate travel, insertion into host communities, and employment. While some dahira focus on mutual assistance among members, others contribute to public works projects and serve as civil society partners for the state and non-governmental organizations.

Members of Matlaboul Fawzaini collected annual dues and special contributions for the hospital project in Africa, Europe, and North America over a period of ten years. Between the time of groundbreaking and the completion of the hospital in 2003, the various chapters of the dahira contributed an astounding FCFA5 billion (US$10 million).19 Upon its completion, Matlaboul Fawzaini handed the hospital keys to the then Mouride Khalife-General, Serigne Saliou Mbakke.20 Serigne Saliou designated the Ministry of Health as the structure that would become responsible for ensuring the hospital's ongoing operations.

Five individuals, including the hospital director and his chief of staff, arrived at the hospital structure early in 2005 with the charge of making it operational; they found empty buildings with no furniture, no medical equipment, and no supplies. Less than 18 months later the hospital employed nearly 200 clinical and auxiliary personnel, the majority of whom were being paid with the hospital's own revenue. It has since become a Level III National Hospital under the jurisdiction of the Senegalese Ministry of Health, and it is the only hospital to have this technical designation outside of the capital city Dakar.

The earliest formulation of the organization that was to become Matlaboul Fawzaini emerged under the leadership of Daam Ndiaye, a dynamic Mouride emigrant who settled in Spain in the mid-1980s.21 He became president of the Mouride dahira of Madrid, and was the first Senegalese to own a boutique in Spain. In 1990, upon the occasion of Serigne Modou Bousso Dieng Mbakke's visit, Ndiaye launched the idea of a project that would be funded by all of the Mouride dahira in Spain: a project to build a hospital in Touba.22 In 1991 Ndiaye received the Khalife-General's permission to begin the project and he created the Association des émigrés sénégalais au service de Cheikh Amadou Bamba.23

Members of Ndiaye's association began collecting funds for the hospital, but financial support faltered after a year. After convening a meeting in Touba in 1994 with at least a thousand Mourides in attendance, Ndiaye finally launched a dahira with sufficient institutional heft to manage the project. The dahira was named Matlaboul Fawzaini, which references a poem written by Amadou Bamba in the 1880s after he discovered the site that would become Touba. Matlaboul Fawzaini means ‘the search for two happinesses’ (in this world and the next) and it conveys Bamba's utopian vision for the city.24 The poem is essentially a supplication: Bamba prayed that God bless Touba and its inhabitants and that He make of Touba a sanctified city of light, faith, peace, and prosperity. The new dahira set as its central purpose the realization of Bamba's prayer.

Once Matlaboul Fawzaini was established, Mourides became members by purchasing membership cards in sums determined by geographic location and based on an estimation of the relative affluence of the Mouride community in question. Membership cards in African countries cost considerably less than cards sold in Europe and North America. Membership dues were renewed annually in the form of sas, a longstanding Mouride fundraising practice.25 Matlaboul Fawzaini soon became the first dahira to take the form of a non-governmental organization (NGO) with bylaws, board members, and a salaried staff. It is now recognized by the government of Senegal as a tax-exempt non-profit organization. The dahira has over 60,000 members with national chapters and a global headquarters in Touba. Daam Ndiaye served as president throughout the 1990s and beyond the completion of the hospital project.26

The hospital's construction began in 1994 on a site donated by the Khalife-General. A turning point came two years later when Serigne Saliou selected a group of medical professionals to tour the construction site and to provide feedback on the project. Taking advantage of the Minister of Health's visit to Touba, a strategic meeting was organized that assembled dahira members, representatives of the Ministry of Health, and other technical advisers. Although this meeting was an occasion for representatives of the state to influence the hospital project, these experts were hand-selected by the Khalife-General and many of them were Mourides. The man who became the first hospital director, Falilou Diop, was one of the more prominent Mouride civil servants who attended the meeting.27

This technical consultation, which occurred after the dahira had spent approximately US$1.2 million dollars, was clearly long overdue. The advisers concluded that the construction to date was completely inappropriate, and they had the unpleasant task of telling the dahira members that the new structures needed to be torn down. As Falilou Diop explained, the technical team had two options. They could ignore the problems and let construction continue, or they could provide honest feedback about the numerous problems in evidence.28 (The building materials were not up to code, doorways could not accommodate stretchers and other medical equipment, and so on.) The technical team told the taalibe (student or follower of a mystical order), ‘What you have built, it is too small. It is no good. If you want this to be a first-rate hospital, you have to knock down what has been built and start over’.29 Heated discussions between the technicians and the dahira members followed, with the taalibe accusing the experts of being soxor (malicious or mean).

There was talk of converting the hospital into a medical centre, but the dahira members decided to persevere and build a Level III hospital. The Khalife-General contributed to the compromise by donating more land so the dahira could expand the structure's footprint. Nearly 80 percent of the structure was demolished and construction began again with guidance from the technical team. Underlying the willingness of the dahira to overcome this setback was the acknowledgement that this medical structure was being built to honour the memory, vision, and spiritual guidance of the Mouride's founding saint. The divine inspiration behind the project contributed in large part to the dahira's determination to see its completion.

Although the dahira finished the hospital, the poor formulation of the original plans has had lasting effects. Doctors and administrators concur that aside from financial problems, the current size of the hospital is their main operational constraint.30 There is not enough space for the current medical personnel and no room for expansion to add other specialties. In 2006 the physical therapy unit was operating in the laundry facility and other specialties were doubled-up and practising in the same wings. This lack of space continues to pose problems for the hospital's day-to-day operations.31 As the chief of staff reflected, ‘money and know-how are not the same’. In spite of the dahira's extraordinary capacity to mobilize millions of dollars for a large project, they did not have the technical expertise to ensure its success. Without the intervention of the Khalife-General, who was the impetus for the technical consultation, many more millions would have been spent on a potential failure.

When the construction of the hospital was nearly complete in 2002 the dahira members presented it to the Khalife-General, who in turn gave the hospital to President Abdoulaye Wade. Serin Saliou told Wade that the Mourides had built the structure to serve the populace of Touba, but that it was his desire that the Ministry of Health oversee its operation. The Khalife-General's gift of the hospital to the state, in the person of Senegal's first Mouride President, is charged with numerous socio-political ramifications.32 It is an admission of the brotherhood's inability to run a complex medical structure, but it also served as an opportunity to leverage state resources for Touba.

The Mourides have always been suspicious of state encroachment in Touba and Sheikh Saliou's attitude was consistent with the tacit division of labour that governs Mouride relationships with the Senegalese government. Mourides have invested millions of dollars to refurbish the Great Mosque, to establish a modern Islamic library, and to build glamorous houses for distinguished guests, but they have also shied away from shouldering investments they see as the state's responsibility. With the Matlaboul Fawzaini hospital, dahira members agreed to raise money for the hospital's construction, but after this initial investment the Khalife-General delegated the cost of running the hospital to the state.

In late 2004 the Minister of Health, Dr Issa Mbaay Samb, contacted Falilou Diop, then the director of one of the most renowned hospitals in the country. In Diop's words, ‘Samb approached me, he told me that the Mourides have built the hospital, and they want me to come run it.’33 Diop agreed to leave his prestigious post in Dakar and he arrived in Touba in late 2004 with a team of four other people. They spent over US $200,000 fixing the remaining construction mistakes and bringing the hospital up to code; the team successfully transformed a set of empty buildings into a functioning hospital in less than four months. President Wade and the Minister of Health inaugurated the hospital on 25 March 2005. By 2006 it employed 190 people, only 60 of whom were civil servants paid by the Ministry of Health.34 The hospital paid the remaining staff with funds generated by its own activities.35

A place-making project extraordinaire: the city of Touba, Senegal

Hôpital Matlaboul Fawzaini offers a significant example of the capacity of overseas emigrants to conceptualize, fund, and implement projects that would normally fall within the portfolio of the state. The financial and human resources mobilized by the dahira bolster the arguments of scholars who see in diaspora organizations tremendous potential to become development actors. Yet the pursuit of ‘development’ is not the raison d'être of Matlaboul Fawzaini. Instead it has dedicated itself to a central Mouride objective: building the holy city of Touba as the realization of the founding saint's holy vision. Matlaboul Fawzaini's hospital is less an achievement of ‘development’ than of bringing Touba a step closer to Bamba's vision for the city, which increases the symbolic capital of the dahira at the same time.

Throughout the Muridiyya's history realizing Bamba's dream for Touba has served as its central project. Bamba established the city after being visited in a vision by the angel Gabriel, who told him that the site would become a spiritual metropolis of universal significance.36 After Bamba's death in 1927 his sons and successors began the actual construction of the city. The Great Mosque in Touba, the site of Bamba's mausoleum, was constructed over several decades and is the largest mosque in sub-Saharan Africa. Touba is a spiritual and an economic beacon; for the past 50 years it has attracted rural migrants seeking relief from drought and ongoing economic crisis. Its population growth over the past 50 years has astounded scholars and politicians alike – Touba counted 2,127 residents in 1958, and this number grew to 125,000 by the late 1980s. The population reached 300,000 by 1993, and current estimates are between 800,000 and one million.37

Building the city of Touba has not only been the central project of the Mourides, but also one that has been accomplished with little assistance from non-Mourides, including the government of Senegal. Touba is a socio-political enclave within the Senegalese state; the Khalife-General and his advisers oversee Touba's expansion and development. The Muridiyya reserves the right to alienate and distribute land in Touba. Urban settlement has proceeded in successive waves of lotissement (land allocation) organized by the khalifes.38 The bureaucratic and rationalizing impulse of the Senegalese state has never successfully reached Touba and it has remained largely illegible and impenetrable to outsiders, from state authority to development actors.39

In spite of its unique administrative status, Touba faces similar challenges to other rapidly expanding locales. The demands of urban life pose new challenges for the Mouride leadership, particularly in the context of extending infrastructure such as sanitation, health care, and housing to meet the needs of Touba's growing population. What distinguishes Touba from other urban centres is that religious leaders can deploy the religious devotion of Mouride disciples to mobilize vast sums of money and labour for major urban projects. In the absence of state authority and state resources to manage Touba's development, a social field has emerged in which Mouride associations jockey for prestige and baraka (blessings) from the Khalife-General through their efforts to construct the holy city. As the good works of Mouride dahira are playing an increasingly important role in managing Touba's development, the ability to marshal the earning power and labour of dahira members has catapulted several large dahira, like Matlaboul Fawzaini and Hizbut Tarqiyaa, into positions of prominence.

Touba is also a site where personal ambitions and dreams are realized. Regardless of their country of residence, most Mourides attempt to make the annual pilgrimage to Touba on the occasion of Magal, the celebration of Bamba's return from a seven-year exile in Gabon. Magal provides an occasion for receiving Bamba's baraka through the mediation of his successors and for renewing allegiance to one's marabout.40 In addition to the annual Magal, many Mouride migrants build impressive villas in Touba as expressions of their financial success, which also serve as evidence of the baraka that Bamba bestows upon his hardworking and pious followers. The final aspiration of Mouride taalibe is to be buried in the holy city after death, thereby securing Bamba's blessings as they move to the afterlife. Touba is a complex signifier for Mourides, and a space that has become meaningful through the execution of both collective and individual projects.

Several significant changes in the internal dynamics of the Muridiyya underpin the emergence of the hospital project as the central aspiration of a large collective of overseas Mourides. With the growth of the Mouride diaspora, Touba itself is becoming an increasingly global locale, that is, a locale produced at the intersection of global movements of people, material resources, and ideas.41 As migrants spend longer periods of time away from Senegal, Touba has come to occupy a prominent place in the imagination of transnational Mourides. In response, taalibe who share a deep commitment to achieving Bamba's vision are forging new social connections and transcending traditional scales of human interaction to reproduce dahira abroad and to create the holy city at home. The increasing reliance on migration as a key economic strategy for Mouride disciples has reinforced attachment to Touba as the centre of the global Mouride diaspora, ‘The logic governing Mouride mobility requires the constant presence of the Touba sanctuary … . There is an undeniable concomitance between the construction of the point of reference [Touba] and mobility.’42

The dahira that launched the hospital project illuminates the convergence of these recent trends. As a transnational dahira with over 60,000 members in Europe and North America, Matlaboul Fawzaini offers its adherents an extensive network for insertion into host communities and adaptation to life abroad. At the same time, the dahira's commitment to being an engine of development in Touba reveals its members' spiritual attachment and nostalgia for the holy city, and their desire to participate in the ongoing construction of Touba even from afar. The elaborate organizational structure of the dahira, and its success in attaining the status of a legal non-profit organization, reflect attempts by Mouride taalibe (and Mouride intellectuals in particular) to modernize the brotherhood's activities and reputation at home and abroad.43 Although the hospital is a development project of sorts, it is also the culmination of migrant longing for the spiritual homeland, a reflection of their commitment to achieving Bamba's vision of the holy city, and a display of the dahira's financial and symbolic capital.

Baraka or biomedicine? The hospital as a unique therapeutic structure

Reflecting the multiple and complex motivations behind its construction, the hospital has taken shape as a distinct place where science, faith, technology, and baraka converge. This convergence occurs in social relations at the hospital as well as in its physical structure – the hospital's departments are organized around a central courtyard that is equipped with both a mosque and a helicopter landing pad. The hospital's origin as a taalibe-initiated project shapes how Mouride patients interact with the medical personnel, how they assess the quality and cost of the care they receive, and their sense of ownership of the hospital itself. Hospital personnel feel that they have a mandate to heal the sick and to relieve suffering, and to emulate the pious work ethic and solidarity that produced the hospital in the first place. A sense of a divine mission underlies therapeutic encounters and other social interactions at the hospital.

When asked what might be different about the hospital, given its origins as a religious project, most employees were quick to stress that it is a modern biomedical facility that functions like any other hospital.44 The prestige of being the only Level III hospital outside of Dakar is central to the pride that medical personnel and dahira members take in Hôpital Matlaboul Fawzaini. Yet in the wake of assertions about the hospital's modernity and technical sophistication, evidence of its particularity emerge. ‘There is the tendency for hospital staff to transform themselves into taalibe when important marabouts arrive at the hospital,’ one doctor acknowledged.45 In the presence of high-ranking marabouts, some hospital staff forgo professional conduct and enact taalibe–sheikh relations by prostrating themselves on their hands and knees in front of their religious superiors (who also happen to be patients).

Staff narratives offer a clear indication that there are numerous personal and professional motivations behind their work at the hospital. All of the hospital's top administrators had distinguished careers before arriving at Hôpital Matlaboul Fawzaini. Given Touba's distance from Dakar, which for Senegal's intellectual class represents ‘all of Senegal’, these doctors and administrators relinquished far more prestigious, comfortable, and in most cases more lucrative positions to work at the hospital. Some of the attraction came from wanting to be part of something entirely new. ‘Building a functioning hospital from scratch is not something you often get to do in the course of a normal medical career’ explained one doctor.46

For the Mouride intellectuals working at the hospital, mystical and religious motivations weighed heavily in their decision to relocate to Touba. In recounting their stories, they convey that their professional work at the hospital is infused with religious significance and animated by the Mouride ethic of khidma.47 One young doctor described his choice in the following manner:

We came to Matlaboul Fawzaini leaving behind us greater opportunities for material advancement, but as young men who love our country and have a desire to serve it, and as disciples of Sheikh Amadou Bamba, who suffered so much for his people, we thought that our place was here … to bring our contribution to the well being of our compatriots and fellow disciples.48

Other doctors and medical personnel described their willingness to forgo the comforts of Dakar for the chance to contribute in such a fundamental way to the residents of Touba and to realizing Bamba's vision.

Touba exerts a strong pull on Mourides in the diaspora and throughout Senegal. Just as a sense of being called to fulfil Bamba's mission features prominently in dahira members' stories about the hospital project, so the Mouride staff reflect on their own attachment to Touba. This mystical connection figured prominently in the story of the Human Resources Director, who had spent most of his career far from both Dakar and Touba. In one interview he stressed that he had known for some time that he was going to end up in Touba, largely because of successive dreams in which he was being called upon by various deceased Mouride sheikhs.49 He spoke of the conversations he had with them in these dreams, and of his growing sense that Touba was calling him. ‘When I got my assignment to come here,’ he said, ‘I wasn't in the least surprised.’

Even non-Mouride staff report being influenced by the sense of devotion that Mouride taalibe bring to their work at the hospital and in Touba more broadly. Touba looms large in the Senegalese landscape because it occupies a space outside the bounds of the state and because of the renowned religious zeal of Mouride taalibe. Touba's distance from Dakar, its extreme heat, and the local ban on alcohol, tobacco, movies, and music create an image of a puritan and inhospitable place. This reputation extends to the world of donors and NGOs – there is almost no presence of any of the major development agencies that are active in Senegal in the holy city. These agencies (and to some extent state structures) are reluctant to accept the necessary compromises and sharing of power that operating in Touba would require.

For all of these reasons, one young doctor spoke of his disappointment after he had been assigned to the Touba Health Centre for his four-month medical residency. He assumed that daily life in Touba would be tedious and difficult, and he hoped to be relocated as soon as possible. The doctor continued, ‘I told my supervisor I would try to make it through the first month, but then I would have to be transferred elsewhere.’ Instead, after only a few weeks, he was ‘seduced’ by the atmosphere in Touba, by the Mourides' organizational capacity, and by their willingness to work hard for the benefit of the population. He concluded, ‘Like many of my colleagues, coming to this hospital was a challenge that I took with some misgivings. But we are rewarded every day by what we have been able to achieve in only one year on behalf of the population of Touba.’50 He added that he can imagine spending a good portion of his career in Touba.

In spite of their varied itineraries and different motivations for accepting their posts at the hospital, there was a widespread consensus among the staff that they are all working harder in Touba than they would in most other medical facilities. They are driven to meet the acute needs of the population of Touba, and also by the sense that they are working to fulfil a divine mission that Matlaboul Fawzaini entrusted to them. The origins of the project as homage to Serigne Touba continues to shape the daily practices of the personnel who are now charged with carrying out its medical and administrative functions. For the dahira members and the hospital staff, the technologically sophisticated hospital is a symbol of a modernizing Touba, but it is also the concrete realization of Bamba's vision and evidence of his continued blessing of the holy city.

Dahira and public–private partnerships: an alternative to state-led development?

In spite of its rocky beginning and operational constraints, the hospital addresses an acute need for biomedical infrastructure in Touba itself and the surrounding region. There has been little to no expansion of government medical services in Senegal for the past two decades. Hôpital Matlaboul Fawzaini is one of two hospitals in the region of Juurbel with a total population of almost 2 million residents.51 While the hospital provides an example of transnational civil society filling the gap between citizen needs and state capacity, the short- and long-term viability of this kind of development remains uncertain. The dahira's responsibility for the hospital ceased in 2002, and the current administrators and staff face ongoing challenges.

The most evident set of problems at the hospital are those related to its current capacity in the light of Touba's population growth. Administrators estimate that the structure needs to double in size (from three to six hectares) to achieve its potential as a hospital with Level III ranking. The director of human resources cannot hire additional staff because of the shortage of space.52 Doctors express frustration with the space constraints; except in rare cases they need to discharge patients after three or four days because of the bed shortage. Both clinical personnel and administrators blame these problems on the lack of foresight with which the dahira undertook the project.

The other major impediment to the hospital's functioning is related to finances, and the fragile balance of responsibility between the Ministry of Health, the hospital administrators, and the Muridiyya for the hospital's operating costs. During interviews in 2006, the hospital staff asserted that the hospital falls within the administrative hierarchy of the state. As salaried civil servants they wanted to make claims on the Ministry of Health to obtain additional personnel and financial support for the hospital. Yet at that time the hospital received an annual budget of US$660,000 from the Ministry of Health, which covered approximately 50 percent of its costs. The remaining expenses were being covered by the hospital's own revenues. The hospital is now accumulating debt and must occasionally divert patients to other medical structures to obtain pharmaceuticals.53

In spite of the hospital's status as a state structure, the hospital administrators are keenly aware of the social and political stakes involved in receiving financial assistance from both the state and the Mourides. They currently have many needs and are continually sending requests to the Health Ministry for additional support.54 The unofficial response is that the hospital should go to the Khalife-General and ask the Muridiyya to make up the difference between the hospital's overhead and state financing.

There are several ways to read this response. It could be understood in the broader context of the muted political tension spurred by Mouride aspiration for autonomy versus the state's desire to extend its control over the Mouride heartland. In the recent past, this tension was expressed in the form of Mouride resistance to the introduction of state-sponsored French education in Touba and opposition to ending the free supply of water in the holy city. It also could be an allusion to the weak capacity of the state, or an attempt to test the Sufi order's seemingly inexhaustible ability to mobilize labour and capital. For their part the hospital administrators understand that returning again and again to the Muridiyya for financial assistance could be perceived as a subtle allegation that the Health Ministry is failing to support the hospital. In the potentially contentious realm of state–tariqa politics, such a critique could easily result in backlash against the hospital itself and a loss of existing state funding.

The political ramifications of these funding sources are perceived differently by actors inside and outside of the hospital. During a tour of the hospital the chief of staff spoke openly about the hospital's financial challenges, the shortcomings of the hospital's current structure, and the seemingly endless need for more money.55 On the tour was a high-ranking marabout who was part of Serigne Saliou's circle of advisers. This marabout, who had not previously visited the hospital, suggested that Serigne Saliou could easily remedy any of the hospital's needs. In his words, ‘If Matlaboul Fawzaini can't continue financing the hospital, someone else will take over. We can get other taalibe to provide the funding.’

Although the chief of staff sees his financial challenges as symptomatic of Senegal's underfinanced health system, his religious counterpart alluded to the ability of the Mouride leadership to tap into the vast capacity of the brotherhood. His enthusiasm for the hospital contrasts with apparent government reservations about increasing its funding. As a dahira-initiated project, its success can be counted as part of the broader legacy of the Muridiyya. The structure is definitively a Mouride hospital. The social and political capital accrued by the dahira and the Khalife-General from successfully bringing such an ambitious project to fruition will never be extended to the state.

In the light of the permanent association between the hospital and the taalibe who financed its construction, the state has little to gain by increasing its support of the hospital. Given the historical conflation of the state with the ruling party in Senegal, state legitimacy stems from the ruling party's monopoly over state resources and their distribution through party networks.56 In exchange citizens reward party leaders with electoral fidelity. This clientelist system leaves little room for state enthusiasm in response to projects initiated by civil society, which carry an implicit critique of the state's shortcomings. While it would have been difficult for President Wade to deflect the Mouride's gift of the hospital to the citizens of Senegal, the insufficient funding the hospital has received to date reflects limited means and state ambivalence about supporting a Mouride project. The current financing reflects a compromise in which the state provides just enough financial support to deflect accusations that it has abandoned Touba.

The state's ambiguous relationship with the hospital is even more intriguing since the government continues to show a commitment to enhancing the city's infrastructure. In the past state investment in Touba was a means of ensuring the continued loyalty of the Khalife-General, and thus securing his ndigal (recommendation), which guaranteed Mouride support in presidential elections.57 President Wade has devised his own project for Touba, for which he has pledged an investment of CFA200 billion over ten years to build new roads and to extend the electrical grid and water supply. Wade's attitude indicates that the state is more interested in garnering credibility through its own initiatives in Touba than in supporting Mouride projects, even when the latter respond to the immediate needs of the population.58

What future for diaspora development in Senegal and beyond?

Within the context of Senegal's deep Islamic history and vibrant Sufi landscape, the Mourides have long attracted the attention of scholars and researchers for their dynamism and their ability to transcend major shifts in Senegal's political economy over the past 100 years. Recent scholarship has examined how this Sufi order, and particularly Mouride dahira, have been remarkably adept at harnessing new social and economic conditions. The Mouride diaspora offers an example of ‘globalization from below’ whereby ‘small players, as opposed to mega-corporations, make use of the opportunities offered by globalization’.59 In contrast to early theorizing about globalization which anticipated cultural homogenization, the Mourides have continued to ‘appropriate the possibilities offered by globalization … to take advantage of it and to be borne by it in every sense of the word’.60 Mouride dahira reflect changing social circumstances internal to the Muridiyya and the ways that the Sufi order has capitalized, literally and figuratively, on transnational migration as an economic strategy and source of symbolic capital.61

Matlaboul Fawzaini is not unique in its transnational membership, but it provides a remarkable example of the potential scale and capacity of diaspora associations. After a slow beginning, the dahira established a successful transnational bureaucracy that effectively coordinates chapters in a half-dozen countries with tens of thousands of members. By becoming a formal NGO registered in Senegal, it has numerous advantages over more ad hoc diaspora associations, including its minimal tax burden and its ability to import materials and equipment duty-free.

The vast sums of money raised for the hospital, the successful completion of the construction project, and the ability to sustain the project for more than a decade are unprecedented for a Muslim organization in Senegal. In contrast, secular NGOs in Senegal run by migrants that focus on translocal development have had difficulty mobilizing resources for their projects.62 Without the motivation of religious piety or a sense of allegiance to a collective spiritual project, most migrants use their remittances for family welfare and expect the state to provide for basic needs and infrastructure.63 ‘Development’ as an end in itself does not appear to be a compelling objective for savings or investment.

In spite of its successes, over the past several years Matlaboul Fawzaini has suffered from a crisis of leadership. Accusations of corruption levied against several of its members and ensuing struggles to wrest control of the dahira from the current leadership have stalled attempts to pursue equally ambitious projects. This crisis reflects new tensions between the increasingly numerous descendants of Amadou Bamba and a dynamic generation of young Mouride disciples. While the former claim a right to power and leadership based on saintly genealogy, the latter stake their credibility on their ability to help fulfil their sheikh's ambitions for Touba.

The leadership conflict also illustrates the growing fault line between arabisants (Mouride intellectuals with a Koranic education and little or no literacy in French) and francisants (Mourides with degrees from francophone institutions). Daam Ndiaye, the dahira's first president, stems from the arabisant group, and his authority has been challenged by francisants. While francisants have little interest in the more traditional dahira that help rural migrants adapt to urban settings, Matlaboul Fawzaini's tax-exempt NGO status offers a platform for lucrative business opportunities and as such has become an arena of contention.64 Rather than being coopted by the state or harnessed for state-coordinated development projects, the dahira faces internal threats to its continued operation.

In addition, as with all things in Touba, future development efforts must receive the blessings of the Khalife-General. The passing of Serigne Saliou Mbakke in 2008 and of his successor Mouhamadou Lamin Bara Mbakke in 2010 have ushered in a new era for the Muridiyya. It is too early to assess the extent to which the new Khalife-General, Serigne Cheikh Sidi Mokhtar Mbakke, will embrace and facilitate diaspora- or dahira-initiated projects in the holy city. The longevity and future efficacy of Matlaboul Fawzaini are far from certain.

As a product of African transnational organizing, Hôpital Matlaboul Fawzaini illustrates the varied motivations behind diaspora projects, the distinctive processes by which these projects come to fruition, the tremendous potential of diaspora philanthropy, and the numerous problems that can plague its execution. As scholars have found in studies of hometown associations in Mexico, Cameroon, and Tanzania, these associations often have limited skills in project management, and their identification of need does not always coincide with the most immediate development needs of their home community.65 The difficulties that plagued the Mouride hospital project echo these concerns – the project was poorly conceptualized, the dahira did not have the technical expertise to design a hospital, and over US$1 million was wasted on inadequate construction before outside technical consultants helped redesign the building plans. Although the region lacked a top-tier hospital, the health of Touba's inhabitants could easily be improved with access to clean drinking water, adequate nutrition and shelter, a robust sanitation system, and comprehensive primary health care.66

The rise of diaspora-sponsored projects raises a nexus of questions about the development role for states in the neo-liberal moment, competition and collaboration between state and non-state actors, and the very future of the development paradigm itself. Some scholars express concern that ‘such projects disproportionately burden migrants and make them responsible for functions that rightfully belong to states’.67 Okome argues that regardless of what remittances can accomplish in African settings, they should be considered only an adjunct to state efforts to combat poverty and marginalization.68 Those most enthusiastic about diaspora development see the potential for states to regain some of their diminished resources, to leverage the value of remittances to obtain credit in international finance markets, and to partner with dynamic diaspora groups that can conceptualize and execute small-scale projects.69

In spite of the global trend for ‘development’ funded by private capital investment, the Senegalese state displays tremendous ambivalence about diaspora-initiated projects. In an interesting twist on state–brotherhood relations, the transfer of the hospital to the Ministry of Health afforded the Mourides an opportunity to secure additional state resources on terms of their choosing. Bestowing the hospital structure on the Senegalese government forced it to accept fiscal and technical responsibility for its functioning. Although in many situations non-state actors are replacing the state's historical functions, this case suggests that diaspora associations can wrest new commitments from the state by successfully completing infrastructure projects. Yet the Senegalese government has only partially embraced the hospital, primarily because it stands to gain little legitimacy from the success of a Mouride project.

The case of Matlaboul Fawzaini highlights the distinct processes and outcomes of diaspora projects. The hospital stemmed from a unique constellation of religious motivations, economic opportunities, and transnational collaboration. The possibility of replicating this development strategy, even by Matlaboul Fawzaini itself, is far from obvious. Even the most ardent supporters of diaspora development acknowledge that remittances are not public money but personal flows, and states may have little ability to direct these resources towards sustainable or equitable development projects.70 States and non-state actors may also have competing motivations, as seen in the reluctance of the Senegalese state to expend resources that won't reinforce its own legitimacy.

Given the limited reach and competence of many African states, the enthusiasm for remittances as a lifeline for the poor and a panacea for a development comes as no surprise. Our analysis reinforces the conclusion that there is no replicable model for international development or public–private partnerships to be derived from the complex and contingent projects pursued by transnational migrants.71 In spite of the Mouride penchant for innovation and mobilizing vast material resources, it is unclear whether a Sufi organization (or any non-state actor) can manage a city that will soon have over a million residents. Touba's status as a religious enclave creates particular challenges for its development and for state–Mouride collaboration.

Although Matlaboul Fawzaini undertook a project designed to benefit Touba and the surrounding region, we should remain mindful that remittances and diaspora philanthropy privilege some families, communities, and regions while others are doubly marginalized by state neglect and the lack of resources transferred by transnational migrants. As a product of the uneven expansion of global capitalism (which in many cases has overtaken state-led development) the economic investments of diaspora associations are bound to be equally sporadic and unsystematic.72 The extent to which the individual and collective savings, projects, and dreams of Africans living in global diasporas can remedy the ills of a marginalized continent remains to be seen.

Peggy Levitt and B. Nadya Jaworksy, ‘Transnational migration studies: past developments and future trends’, Annual Review of Sociology33 (2007), pp. 129–56.
Cheikh Anta Babou, ‘Brotherhood solidarity, education and migration: the role of the dahiras among the Mouride Muslim community of New York’, African Affairs101, 403 (2002), pp. 151–70; Sophie Bava, ‘De la baraka aux affaires: ethos économico-religieux et transnationalité chez les migrants sénégalais mourides’, Revue Européenne de Migrations Internationales19, 2 (2003), pp. 69–84; Mamadou Diouf, ‘The Senegalese Mouride trade diaspora and the making of a vernacular cosmopolitanism’, Public Culture12, 3 (2000), pp. 679–702.
Dilip Ratha, ‘Leveraging remittances for development’ (Paper, Second Plenary Meeting of the Leading Group on Solidarity Levies to Fund Development, Oslo, Norway, 2007). Most scholars estimate that officially recorded remittances make up 50 percent or less of total remittances.
Dilip Ratha and Zhimei Xu, ‘Migration and Remittances Factbook 2008’ (The World Bank, Washington, DC, 2008).
Barbara Merz, Lincoln Chen, and Peter Geithner (eds), Diasporas and Development (Harvard University Press, Cambridge, MA, 2007).
Giles Mohan, ‘Embedded cosmopolitanism and the politics of obligation: the Ghanaian diaspora and development’, Environment and Planning A38, 5 (2006), pp. 867–83.
George Bob-Milliar, ‘Chieftaincy, diaspora, and development: the institution of Nkgraphicsuohene in Ghana’, African Affairs108, 433 (2009), pp. 541–8.
Ralph Grillo and Bruno Riccio, ‘Translocal development: Italy–Senegal’, Population Space and Place10, 2 (2004), pp. 99–111.
Claire Mercer, Ben Page, and Martin Evans, Development and the African Diaspora: Place and the politics of home (Zed Books, London and New York, NY, 2008).
Samuel Maimbo and Dilip Ratha (eds), Remittances: Development impact and future prospects (The World Bank, Washington, DC, 2005), p. 2; Ratha, ‘Leveraging remittances for development’.
The Muridiyya is a Sufi order that originated in Senegal in the early twentieth century. It is the most widespread and fastest-growing Muslim brotherhood in Senegal. For more on the history of the Murid order see Cheikh A. Babou, Fighting the Greater Jihad: Amadu Bamba and the founding of the Muridiyya of Senegal, 1853–1913 (Ohio University Press, Athens, OH, 2007); Jean Copans, Les Marabouts de l'arachide (L'Harmattan, Paris, 1988); Donal C. O'Brien, The Mourides of Senegal: The political and economic organization of an Islamic brotherhood in Senegal (Clarendon Press, Oxford, 1971); Cheikh T. Sy, La Confrérie sénégalaise des mourides (Presence Africaine, Paris, 1969).
Mercer et al., Development and the African Diaspora.
Mohan, ‘Embedded cosmopolitanism and the politics of obligation’.
Three major trends can be discerned in the scholarship on the Mourides. Early scholars were concerned with the order's political significance as an instrument for the adaptation of the Wolof ethnic group to colonial rule. A second trend focused on the economic dimension of the Muridiyya and emphasized its contribution to the expansion of peanuts as a colonial cash crop. A later trend explores the urbanization of the order and the emergence of a global Mouride diaspora. For an exploration of these different trends and their sources see Babou, Fighting the Greater Jihad, pp. 2–4.
Copans, Les Marabouts de l'Arachides; O'Brien, The Mourides of Senegal.
Diouf, ‘The Senegalese Mouride trade diaspora’, p. 681.
Babou, ‘Brotherhood solidarity, education and migration’.
The hospital project is exceptional for its duration, scale, and the amount of money raised. In his study of Mexican hometown associations, Orozco found that most groups attempted projects that cost US$10,000 or less and that few associations last longer than ten years. Manuel Orozco, ‘Hometown associations and their present and future partnerships’, USAID report, Washington, D.C. (2003).
The Khalife-General is the religious head of the Mourides. After Bamba's death in 1927 his sons and then grandsons succeeded one another in this position at the top of the organization.
Interview, Moustapha Thioune, founding member of Matlaboul Fawzaini-New York, New York, 12 July 2007.
The late Serigne Modou Bousso Dieng Mbakke was the elder son of Serigne Falilou Mbakke, second caliph of the Muridiyya (1945–68). Serigne Modou Bousso first grabbed the limelight when he challenged the leadership of his uncle, Caliph Abdou Lahad (1968–88). They reconciled and he gained notoriety for the supposed efficacy of his prayers to help people get visas, especially for Europe. He travelled abroad frequently and had a large following among the Mouride diaspora.
Cheikh Gueye, Touba: La capitale des Mourides (Karthala, Paris, 2002).
Ibid., p. 249; Eric Ross, Sufi City: Urban design and archetypes in Touba (University of Rochester Press, Rochester, NY, 2006).
The Wolof word sas can be translated as load, assignment, or duty. It refers to a cash sum or amount of work that Mouride leaders request from their disciples individually or collectively to complete a task. During the course of building the hospital the highest annual sas requested by the dahira amounted to CFA100,000 ($200). Interview, Moustapha Thioune, New York, NY, 12 July 2007.
Gueye, Touba: La capitale des Mourides.
Interview, M. Saar, hospital chief of staff, Touba, 12 May 2006.
Interview, Falilou Diop, hospital director, Touba, 20 May 2006.
Interview, M. Saar, hospital chief of staff, Touba, 12 May 2006.
Ibid.; Interview, Amadou Diouf, Elhadj Dieng, Abdoulaye Wone, Boly Diop, and Aynina Gueye, hospital physicians, Touba, 13 May 2006.
Rebecca Sheff, The Problem with Eating Money: Remittances and development within Senegal's Mouridiyaa (unpublished Honours thesis, Macalester College, 2009).
The history of the Mourides is one of confrontation and accommodation to the French colonial state, and compromise with the post-colonial state for influence over Senegal's citizens and disciples. See David Robinson, Paths of Accommodation: Muslim societies and French colonial authorities in Senegal and Mauritania 1880–1920 (Ohio University Press, Athens, OH, 2001); Leonardo Villalon, Islamic Society and State Power in Senegal: Disciples and citizens in Fatick (Cambridge University Press, Cambridge, 1995); and Donal C. O'Brien, Symbolic Confrontations: Muslims imaging in the state in Africa (Palgrave Macmillan, New York, NY, 2003).
Interview, Falilou Diop, hospital director, Touba, 20 May 2006.
By 2008 the hospital staff had grown to 260 employees. Sheff, The Problem with Eating Money, p. 60.
Like all government health structures in Senegal, the hospital is run on a model of partial cost recovery. It charges user fees for medical appointments and for hospitalization, and also sells pharmaceuticals and other medical supplies to patients.
Gueye, Touba: La capitale des Mourides; Ross, Sufi City.
Gueye, Touba: La capitale des Mourides.
Ibid.; Ross, Sufi City.
James C. Scott, Seeing Like a State (Yale University Press, New Haven, CT, 1998).
Christian Coulon, ‘The grand Magal in Touba’, African Affairs98, 391 (1999), pp. 195–210.
Saskia Sassen, A Sociology of Globalization (W. W. Norton and Company, New York, NY, 2007), p. 132; Zsuzsa Gille and Seán Ó Riain, ‘Global Ethnography’, Annual Review of Sociology28 (2002), pp. 271–95.
Diouf, ‘The Senegalese Mouride trade diaspora’, p. 698.
Interview, S. Seck, hospital social work director, Touba, 30 May 2006; Interview, J. Bogol, Matlaboul Fawzaini physician, Touba, 17 May 2006; Interview, Amadou Diouf, El Hadj Dieng, Abdoulaye Wone, Boly Diop, and Aynina Gueye, hospital physicians, Touba, 13 May 2006.
Khidma means service to others, and it was used by Amadou Bamba alongside the concepts of amal (labour) and kasb (gains) to refer to work. Khidma differs from the other concepts in that, in Bamba's view, it signifies work in the name of God for the sake of rewards in the hereafter.
Interview, Issa Ndiaye, Touba, 31 May 2006.
Interview, Amadou Diouf, Elhadj Dieng, Abdoulaye Wone, Boly Diop, and Aynina Gueye, hospital physicians, Touba, 13 May 2006.
The Henrich Lubker hospital built by German cooperation in Diourbel in the 1960s was barely functional throughout the 1980s and 1990s. European donors approved funding to rehabilitate the hospital in 2004.
Interview, Issa Ndiaye, Touba, 31 May 2006.
Sheff, The Problem with Eating Money.
Interview, M. Saar, hospital chief of staff, Touba, 12 May 2006.
For further examination of the state and its relations with the citizenry see Momar Coumba Diop (ed.), Le Senegal contemporain (Karthala, Paris, 2002), especially ‘La citoyenneté mise en perspective’ pp. 501–47.
See Linda Beck, ‘Reining in the marabouts? Democratization and local governance in Senegal’, African Affairs100, 401 (2001), pp. 601–21 for an analysis of how historically the state has used investment in infrastructure to leverage political support.
In 2009 the Khalife-General's spokesman issued a scathing critique of the lack of government support for Touba. He highlighted the paltry financing of Matlaboul Fawzaini hospital that was built ‘entirely by talibe’ and receives the least amount of funding of any Senegalese hospital. (Walfadjri, ‘Gestion des affaires de Touba: le porte-parole du khalife general des mourides decrie le laxisme du gouvernement’, 20 November 2009). <http://www.seneweb.com/news/article/26853.php> (20 November 2009).
Giles Mohan and A. B. Zack-Williams, ‘Globalization from below: conceptualizing the role of the African diasporas in Africa's development’, Review of African Political Economy 92 (2002), pp. 211–36, 233. See also Arjun Appadurai, Fear of Small Numbers: An essay on the geography of anger (Duke University Press, Durham, NC, 2006) p. xi.
Diouf, ‘The Senegalese Mouride trade diaspora’, p. 682.
Babou, ‘Brotherhood solidarity, education and migration’.
Grillo and Riccio, ‘Translocal development: Italy Senegal.’
See Sheff, The Problem with Eating Money for a comparison between Matlaboul Fawzaini and L'Association pour le codéveloppement (ASCODE), a secular NGO with many Mouride members.
A similar leadership dispute between arabisants and francisants emerged in the dahira Hizbut Tarqiyya, and the Khalife-General ultimately stepped into resolve the conflict. See Beck, ‘Reining in the marabouts’.
Mercer et al., Development and the African Diaspora; Orozco, ‘Hometown associations and their present and future partnerships’, p. 42.
Touba's residents rely on potable well water brought in from outlying villages by donkey cart, and its lack of a stable water system has facilitated several outbreaks of cholera in the past few years. There are not enough primary health clinics to serve the needs of the city's growing population.
Peggy Levitt and Ninna Nyberg-Sorensen, ‘The transnational turn in migration studies’(Working Paper, Global Commission on International Migration, Global Migration Perspectives, No. 6, 2004), p. 8.
Okome, ‘African diasporas’.
Ratha, ‘Leveraging remittances’; Maimbo and Ratha, Remittances.
Levitt and Jaworksy, ‘Transnational migration studies’; Maimbo and Ratha, Remittances.
Grillo and Riccio, ‘Translocal development: Italy–Senegal’; Mercer et al., Development and the African Diaspora.
Mohan, ‘Embedded cosmopolitanism.’