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- Convenor:
-
Susan Beckerleg
- Stream:
- Human, plant and animal health
- Location:
- G51
- Start time:
- 11 September, 2006 at
Time zone: Europe/London
- Session slots:
- 1
Short Abstract:
none
Long Abstract:
It is now over two decades since AIDS emerged as a serious problem. AIDS is now a leading cause of death in many African countries. Particular social conditions, notably poverty, migration, and war, favour the transmission of HIV. HIV and AIDS impact on the micro-level, in relation to sexual reltionships, marriage, treatment seeking, care of the sick and inheritance. On the macro-level, many African countries are struggling to cope with a workforce weakened by AIDS, a failing helath system and increasing numbers of orphans. These factors all have far reaching social consequences. In the last few years, large injections of cash from PEPFAR in the USA and from the Global Fund have created unprecendated opportunities to develop interventions to tackle AIDS. However, corruption, complacency and mismanagement have undermined HIV prevention efforts and AIDS treatment programmesin many countries. For AIDS to be effectivley tackled, social change must be factored into responses to the epidemic. In this panel we discuss the social changes that AIDS has precipitated and debate the probable direction of change in African societies over the coming decades.
Accepted papers:
Session 1Paper long abstract:
The shape of funerals has been subject to intense debate in Kyela District in Tanzania, a district that also happens to have the second highest prevalence of HIV in the country. Based on fieldwork between 2000 and 2002, I will explore changes to 'Nyakyusa funerals', in a village where burials sometimes took place on a daily basis. In 2002, a series of bylaws were passed, addressing what were described as 'misleading traditions' (mila potovu) of the Nyakyusa. A large proportion of the mila potovu forbidden by the bylaws are concerned with funerals, inheritance, and the resolution of the disputes that so often follow the death of fathers. Furthermore, the bylaws are explicitly concerned with the role of women in maintaining 'misleading traditions', in particular their excessive demands on men to provide food and beer at funerals, and anxiety on the part of men that funerals create opportunities for women to meet their lovers, and contract sexually transmitted infections or HIV. With regard to inheritance, the bylaws are concerned with the rights of widows - to refuse levirate and to continue living in the home of their deceased husband. Although fears about AIDS and the practicalities of maintaining demanding and expensive funerals in a context of high adult mortality frame today's debates, I will consider the debates about 'tradition' also in the context of the ethnographies of Monica Wilson, and argue that the bylaws constitute a challenge to the notion of 'Good Company' after which her most well known ethnography was named.
Paper long abstract:
In the context of the current protocols surrounding VCT, this paper documents the changing responses to AIDS over a period of ten years in a rural area in Kenya. Most research on AIDS has concentrated on the dilemmas of those suffering from the disease. Stigma is frequently the focus of discussion. This research followed a different strategy and canvassed opinion in Kuria families who did not know their HIV status. The demand for testing rather than stigma emerged as the dominant theme. Along with the spread of HIV, Kuria have noted a sharp rise in new kinds of witchcraft and identify two separate fatal illnesses; one AIDS and the other due to a particular form of witchcraft. Since only one of these is taken as sexually transmissible, testing has particular importance in order to determine which is which. Well aware of the risks of HIV cutting a swathe through the community, people expressed a strong demand for mass universal testing as the only way by which this silent sexually transmitted disease can be identified and measures taken for the protection of the community. Local medics refuse to cooperate because the protocols surrounding testing would make such action 'unethical' and even illegal. While communities are asking for a public health approach, the authorities charged with controlling the epidemic still rely on a human rights approach which privileges the rights of the infected individuals over those (as yet) uninfected.
Paper long abstract:
The first cases of HIV and AIDS to be documented in East Africa in 1982 came from a fishing village on the Ugandan shores of Lake Victoria. However, it is only in recent years that it has been recognised that the people living near the lakes in Uganda have been severely affected by the impact of HIV and AIDS. Many of the men, women and children living on the lake shores are engaged in fisheries-related activities. A recent global literature review and a situation analysis in Uganda show that prevalence rates of HIV among fisherfolk are between 4-14 times higher than national prevalence rates. The vulnerability of fisherfolk to HIV and AIDS stems from causes that include mobility, time away from home, access to a daily cash income in an overall context of poverty and vulnerability, demographic profile, the ready availability of commercial sex at landing sites and fishing ports and the sub-cultures of risk-taking and hyper-masculinity among some fishermen. The subordinate economic and social position of women in many fishing communities in low-income countries makes them even more vulnerable to infection than men. There is a danger in such `life-style' summaries that we characterise `fisherfolk' as feckless risk takers. Such a characterisation may prejudice policymakers and affect access to treatment and care as well as prevention support in places where all such resources are in short supply. In this paper we look behind the statistics to the lives of some men, women and children living in lake-side communities in Uganda severely affected by HIV and AIDS to try to illustrate some of the complexity of their day to day lives within `fishing communities' that generalisations mask.