This essay explores connections between political institutions, forms of power, and women's health care concerns from a cultural anthropological perspective. I focus on the roles of different medical establishments among the Kel Ewey Tuareg of Niger - Western-European sponsored, central state, traditional herbalism and Islamic scholarship - in creating, maintaining, and disputing these constructs, through the invention and elaboration of disease categories and through the selective application of medical and reproductive models and technology to women. I also explore women's attempts to manage these forces, as they draw upon a cultural inventory that is alternately supportive and in conflict with their interests.