AIDS in the Shadow of Biomedicine: Inside South Africa's Epidemic

Description

The Bushbuckridge region of South Africa has one of the highest rates of HIV infection in the world. Having first arrived in the area in the early 1990s, the disease spread rapidly, and by 2008 life expectancies had fallen by 12 years for men and 14 years for women. Since 2005, public health facilities have increasingly offered free HAART (highly active antiretroviral therapy) treatment, offering a degree of hope, but uptake and adherence to the therapy has been sporadic and uneven. Drawing on his extensive ethnographic research, carried out in Bushbuckridge over the course of 25 years, Isak Niehaus reveals how the AIDS pandemic has been experienced at the village-level. Most significantly, he shows how local cultural practices and values have shaped responses to the epidemic. For example, while local attitudes towards death and misfortune have contributed to the stigma around AIDS, kinship structures have also facilitated the adoption and care of AIDS orphans. Such practices challenge us to rethink the role played by culture in understanding and treating sickness, with Niehaus showing how an appreciation of local beliefs and customs is essential to any effective strategy of AIDS treatment. Overturning many of our assumptions on disease prevention, the book is essential reading for practitioners as well as researchers in global health, anthropology, sociology, epidemiology and scholars interested in public health and administration in sub-Saharan Africa. Cover About the author Title Page Copyright Dedication Contents Maps Preface and acknowledgements 1: Introduction Biopolitics and HIV/AIDS From biopolitical theory to social specificity Sickness and AIDS: a brief history of Bushbuckridge Organisation of the book 2: Death The sexual hypothesis AIDS as death Stigma of the living corpse Conclusions 3: Blame Biomedicine, gender and the politics of blame Conspiracy theories: Dr Wouter Basson, Americans and wild beasts Witchcraft and the reconfiguration of blame Conclusions 4: Words ‘If I test HIV-positive I will die’ The agency of words Deadly words, unfortunate names, and curses Sickness, silence and discreet speech Conclusions 5: Knowledge Social and material barriers The life story of Reginald Ngobeni Conclusions 6: Dreams Experiencing AIDS, using HAART The significance of everyday dreams The content of ARV-induced dreams The sequences of ARV-induced dreams Conclusions 7: Care Kinship and the diffusion of parenthood HIV/AIDS and marriage HIV/AIDS and childcare Conclusions 8 Conclusions Culture, South Africa, the baby and the bathwater Beyond biomedicine: therapeutic interventions Notes References Index