ethnography

Cosmologies of Credit: Transnational Mobility and the Politics of Destination in China

annette — Wed, 13 Apr 2011 20:00:00 +0000

Residents of Fujian Province on the southeastern coast of China burn spirit money designed to resemble U. S. currency. That stunning confluence of traditional religious practice and modern dreams of western emigration stands as a kind of symbolic center of this book. In her ethnographic study of the people of this region, famous-or infamous, perhaps—for their involvement in “human smuggling” to the West, Julie Y. Chu asks why so many people would honor the dead with images of western materialism. The answers her subjects gave seemed evasive, dismissive: “because so many have relatives in the United States” or “they’re just being superstitious.”

In fact, the spirit money, modeled after American greenbacks, represents a powerful longing that has defined and transformed this region. Nowhere is this desire more obviously monumentalized than in the comparatively luxurious homes, built by “Overseas Chinese” as “vacation homes” or investments, that are springing up throughout the province. For many, those who have miraculously managed all the bureaucratic obstacles and nightmarish dangers to settle in the West have achieved a heroic status that is both idealized and destabilizing for those “left behind.” The culture Chu describes is one that keeps one proverbial eye fixed westward, the other on a provincial life that seems meager and transient. Bags are kept packed.

The book is replete with tales of those still waiting for the call from the “snakehead” (human smuggler) who will expect them to be ready at a moment’s notice to abandon their current lives and embark on a life-threatening journey. Because this activity has so profoundly defined the region and its people, Chu argues that it is part of a “politics of destination,” a pragmatic and forward-looking ideology governed by the prospect of mobility—both geographic and economic.

Because of the frequency of arrests and loss of life in transit, the area is notorious world-wide as a jumping off point for “human smuggling.” Perhaps the worst incident was a tragedy in June of 2000: fifty-eight migrants from Fuzhou suffocated to death in the back of a truck hauling tomatoes from Belgium to Dover. Indeed, the horrifying details of human smuggling bring to mind the inhumanity of the Middle Passage, with the obvious mitigating difference being the migrants’ belief that a better life awaits those who survive. The author writes, “One cannot easily forget the stifling darkness and pervasive disorientation of being crammed into the hull of a ship or into a steel shipping container for anywhere from fourteen to ninety days." She calls it a kind of “entombment at sea,” too literally the fate of many who have attempted the passage.

The tales of horror have done little to dampen the desire, but have only made legal or illegal “visiting” that much more difficult and risky. Residents still fervently study well worn copies of Practical English for People Working in Chinese Restaurants and wait for the call to action. The new foreign-owned homes, left mostly empty by their overseas owners, seem to be proof of a prosperity that, in spite of all obstacles, is still within the grasp of the most resilient.

The book ends beautifully with the clacking of mahjong tiles that, like the spirit money, captures something essential about the Fuzhounese. The author comments on the popularity of the game: “Though winning always entailed personal reward and glory, losing did not necessarily spell individual failure and shame... Sooner or later... the pendulum of luck would swing back in one’s favor.”

Written by: Rick Taylor, April 13th 2011

Why Girls Fight: Female Youth Violence in the Inner City

alicia — Mon, 14 Feb 2011 20:00:00 +0000

By Cindy D. Ness

New York University Press

Ness holds doctorate degrees in Human Development, Psychology, and Anthropology and in Why Girls Fight she blends the theories and research methods from these three fields to discuss female youth violence. Ness argues that the majority of studies tend to examine either individual factors in explaining and understanding youth violence or emphasize sociological, macro-level factors. Ness’ interdisciplinary approach allows her to address how individual girls respond to and navigate the racial and class constraints as well as the limited economic opportunities within their communities.

Ness problematizes previous research on female youth violence. She addresses the racist and classist underpinnings of the term “violent girl” used in studies, noting that much of this research has relied on a framework in which girlhood is viewed through the lens of white, middle-class femininity. Within this framework girlhood is mostly associated with passivity and relational aggression (mean-girl behavior) if any aggression at all. Moreover, within this framework girls are almost always constructed as victims of violence rather than as agents of violence. Failing to address issues of race and class in relation to youth violence, Ness argues that much of the research depicts girls as delinquents or sociopaths and focuses on faults within the individual.

In acknowledging the social realities girls face in two working-class Philadelphia neighborhoods, Ness is able to sidestep this type of moralizing and pathologizing that taints much of the research on female youth violence. Ness offers a brief history on the economic decline of working-class neighborhoods in Philadelphia, noting how once major industries folded and left the city, entire households and even neighborhoods suddenly found themselves without jobs leading to rundown neighborhoods and schools without adequate funding.

Ness also conducts an ethnographic study, interviewing girls from these two respective neighborhoods on why they fight. In providing a space for the girls’ own words, Ness uncovers a complex set of reasons for female youth violence within the two neighborhoods, reasons ranging from a lack of upward mobility within their communities to issues of physical abuse at home. Furthermore, almost all the girls Ness interviews recognize that street fighting is considered a necessary survival skill within their homes and their communities.

Ness’ book is groundbreaking in addressing how mother-daughter relationships relate to female youth violence. Sidestepping the typical mother-blaming that occurs in studies on this subject, Ness examines how the girls’ mothers’ own views on street-fighting affect how they raise their daughters and she sheds light on the unreported incidents of mothers stepping into fights in order to protect their daughters and at times fighting alongside their daughters.

In neighborhoods that value the ability to handle oneself over passivity, Ness’ work clearly demonstrates that a white, middle-class framework of girlhood cannot begin to explain female youth violence and with Why Girls Fight Ness provides a more adequate model for future studies.

Written by: Kristen Lambert, February 14th 2011

The Trashing of Margaret Mead: Anatomy of an Anthropological Controversy

admin — Mon, 08 Mar 2010 17:01:00 +0000

By Paul Shankman

University of Wisconsin Press

What do Phil Donohue, a New Zealand ethnologist, three anthropologist husbands, and a small handful of Samoan girls all have in common? The answer is: Margaret Mead and their roles in a debate that has rocked cultural anthropology since 1983.

The Trashing of Margaret Mead is a fine, funny, discriminating, and at times quite disturbing book. At the heart of the so-called Mead-Freeman Debate was the veracity, meaning, and political uses of the data that Mead collected in 1925 during the ethnographic research that she conducted in Samoa. Her central finding was that Samoan adolescence did not require the storm-and-stress widely seen as part of adolescence, the volatility that characterizes “teenaged” behavior. Mead’s work framed the “nature/nurture” debate: is nature (e.,g. biology and hormones) ultimately responsible for sexual maturation and behavior, or is it nurture (e.g., gender relations and child-rearing)? Is male dominance hard-wired biologically, or can egalitarianism be taught? Freeman chose the former, Mead the latter.

The Trashing of Margaret Mead consists of fourteen chapters arranged into five parts. It is filled with salacious talk, iconic photos, back-channel communication, and an impressive attention to nuance and detail. The two chapters comprising “The Controversy and the Media” remind the reader of the huge splash made in 1983 in anthropology and wider circles by the publication of Derek Freeman’s book, Margaret Mead and Samoa: The Making and Unmaking of an Anthropological Myth. Relatively few people actually read the book, but stories about Freeman and Mead, often wildly misunderstanding and misquoting the latter, circulated in the pages of Time, Newsweek, The New York Times, The Wall Street Journal, and most memorably in the telling by the author, Paul Shankman, on The Phil Donohue Show. Shankman shows with great gusto and clarity that U.S. media and many academics were predisposed to accept Freeman’s claims, however fraudulent.

Part two exposes Derek Freeman the man, but more importantly, the mind. At least once in the early 1960s, while working in Sarawak, Indonesia, Freeman went quite off the rails. In a museum there he once hacked off the phalluses of wooden statues carved by fine Iban craftsmen. Freeman’s instability is near legendary, and Shankman shows this to us with grace and skill by revealing the manic tenor of his writings and the increasingly nasty tone of his correspondence until the very day he died.

The four chapters in part three, “Sex, Lies and Samoans,” cover the life of and influences upon the young Margaret Mead, the conditions of her first fieldwork in Samoa, and the publication in 1928 of Coming of Age in Samoa, which was an extremely popular (and popularizing) book. These chapters read like a scholarly detective story of what the Mead-Freeman debate meant (and continues to mean) to Samoans, and of what Samoan thought, belief, and behavior are like in terms of sexual matters. Special commentary is reserved for the place of the "taupou system" in Samoa by and through which female virginity is valorized and idealized. As in most cultures, Samoan brothers want to have virginal sisters, but Mead, Freeman, and Shankman show that they often want also to get into the pants (or back then, under the grass skirts) of other men’s sisters.

Shankman also revisits the effects of cross-cultural contact with the American military during World War II upon Samoan beliefs and behaviors. Whereas Mead said that Samoans were largely egalitarian, easy-going, and not hung-up about sex, Freeman argued that Mead had gotten it all wrong, that Samoan culture was riddled by status differentials, prone to violence, circumspect with regards to sex, and also “rape-prone.” Freeman contended that Mead was hoaxed during her fieldwork by two Samoan girls who jokingly indicated their usual hunts and haunts for boys. Shankman shows that Freeman was mistaken, concluding that “Freeman not only misrepresented the historical work of others but neglected his own personal experiences in the islands during World War II and his unpublished work on the taupou system.” Shankman shows that Mead got it largely right and that Freeman got it sloppily and willfully wrong on many, many counts.

The Trashing of Margaret Mead should be used in college courses ranging from media studies to cultural anthropology to women’s studies to Peoples and Cultures of the Pacific. Graduate-level seminars could be wrapped around the many significant issues raised here. Shankman’s bulldog-like dedication for many years is as laudable as his prose style is engaging.

Written by: Lawrence James Hammar, Ph.D., March 8th 2010

Gay Fatherhood: Narratives of Family and Citizenship in America

admin — Mon, 01 Mar 2010 09:00:00 +0000

By Ellen Lewin

University of Chicago Press

In this well-written ethnography, Gay Fatherhood, Ellen Lewin examines the choices and the decisions of gay fathers in America, focusing particularly on men who choose to become fathers as gay men, rather than coming out after having had children in a different-sex marriage. Lewin, also the author of the 1993 ethnography Lesbian Mothers, works centrally from Chicago but has found research participants of impressive diversity with respect to race, religion, socioeconomic background, profession, number of children, and relationship to community. All of these elements make for a fascinating read.

The central question in Lewin’s book is one that has become increasingly pertinent and visible, particularly in queer communities, as the gay marriage debate advances in the United States. Does “being gay” simply mean being a man who loves and is sexually attracted to men, or does it imply another separateness, an inherent incompatibility, with a world that is and will always be predominantly straight? And does asserting the latter negate the identity of gay fathers, assuming "father," even "parent," to be the province of the straight world alone? Or does a gay man who chooses to be a father give up his right to identify as "gay?" Or does "parent" come to overshadow, to render irrelevant, the identity “gay”? And if none of the above are true, are there factors beyond the sexual orientation and gender of the parents that would specifically identify a family as a "gay family?"

As is often the case in anthropological research, Lewin explores these questions without ever fully answering them. Given the scope and depth of Lewin’s writing, however, no answer seems to be demanded. By simply displaying the complexity of the lives and relationships of gay fathers—relationships with partners, relationships with children, relationships with other parents, extended families, communities of friends, religious communities, communities of residence—she demonstrates that this is not an issue to be bullet-pointed or oversimplified. Lewin uses her ethnography to delve into the lives of gay families, and to show the complex nexus of identity at which they reside, and at which they must, in contemporary America, continue to reside. A true writer and a true anthropologist, she leaves the prescription of actions to her readers; there is no doubt that engagement with her writing will lead to more considered, and therefore better, action.

Written by: Gemma Cooper-Novack, March 1st 2010

Sex Work and the City: The Social Geography of Health and Safety in Tijuana, Mexico

admin — Sun, 31 May 2009 23:27:00 +0000

By Yasmina Katsulis

University of Texas Press

Most studies of prostitution still focus on the supply side: the women and girls, the boys and men, and the transgender and transsexual people who toil sexually to survive, meet temporary needs, and thrive. An increasing number of studies focus on the demand side: the direct consumers and the globalizing forces that bring them together. Carved down from what was probably a fine Ph.D. dissertation, and founded upon eighteen months of ethnographic fieldwork that she conducted in Tijuana, Mexico, Yasmina Katsulis’s lively and accessible Sex Work and the City does one better. In only eight chapters and 174 pages, interspersed with field-note entries and arresting photos—for example, a family united in picnic but separated by a fence—she also explores the physicians who under- and over-diagnose STDs, the policemen who extort sexual favors, and the many agents who facilitate and profit from the sexual labor of others.

Ethnographic, archival, and other data show that Tijuana’s sex industry is fed by gringo and Mexican male migrant laborers who come and go—the causes and symptoms of staggering degrees of human migration and mobility. I appreciate her caveat about the necessity of squarely confronting centuries-old stigmas of prostitution. Throughout the book, she opposes an epidemiology and popular culture that systematically misrepresents by underestimating the HIV and STD transmissive risks of sex in, or on the way to, marriage. Katsulis demonstrates not just why, but literally how, prostitution’s labor forms and venues structure health and social risks.

She also explores the motivations for entering into, and the various outcomes of sexual labor by contrasting legal, registered sex work with that which is informal and illegal. Her analysis of the Tijuana Regulatory Model of policing and health inspection of The Body Prostitute highlights police extortion and the health and social hierarchies of strip clubs, brothels, alleyways, massage parlors, beaches, and forlorn places. The social and economic contradictions in Tijuana of skin color, gender identity, language, socioeconomic class, and ethnicity produce differing degrees of health, social, and legal hazard.

Apart from a few minor quibbles (her use of the illogical term “HIV/AIDS infection,” the sometimes interchangeable use of “sex workers” and “prostitutes”), Katsulis neglects to point out that pimping is the world’s oldest profession, not prostitution. Some of her claims—for example, regarding the general absence of pimping in Tijuana—are insufficiently grounded in historical, sociological, and ethnographic studies by Schifter, Wardlow, Kulick, Schoepf, Leonard, White, and me. I enjoyed her remarks about sexual praxis, but there was surprisingly little discussion of the tensions between sexual positionality and sexual and gender identity. Her take on “the prostitution debates” in feminism is only three pages in length. She devotes one sentence to what she takes to be one side of the ledger—“Some feminists argue that legalization of sex work serves to normalize and institutionalize the sexual exploitation of women”—which really irked me. The ensuing discussion morphs quickly into yet another Straw Woman argument about “western White feminists.” Katsulis offered her key informants free HIVab tests, but fails to mention IRB concerns and the availability of trained counselors, confirmatory assays, and antiretroviral or other therapies. Finally, the absence of a discussion of religion beyond cultural codes of macho and marianismo precludes her from analyzing a profoundly good example of a marriage:prostitution dialectic par excellence.

These criticisms aside, Katsulis has contributed a polished, well-written, vibrant, and much-needed book. I hope the university press issues a cheaper paperback edition (lower than the $50 hardcover price) so that it may be used in courses in anthropology, gender studies, and public health.

Written by: Lawrence James Hammar, Ph.D., May 31st 2009

Native Speakers: Ella Deloria, Zora Neale Hurston, Jovita Gonzalez, and the Poetics of Culture

admin — Wed, 08 Apr 2009 17:22:00 +0000

By Maria Eugenia Cotera

University of Texas Press

Native Speakers places the work of three foundational female folklorists in conversation to illuminate an often silenced part of feminist intellectual history, the ethnographic and folklore scholarship of women of color. Analyzing the ethnographic and fictional work of Dakota ethnographer Ella Deloria, African American folklorist Zora Neale Hurston, and Tejana folklorist Jovita Gonzalez, the text reveals the numerous factors that led to the marginalization of these three scholars who also happened to be women of color. Exploring how the work of Deloria, Hurston, and Gonzalez negotiates intersections of race, class, and gender in early twentieth century America, Cotera places an emphasis on empire and colonialism. In so doing, she reveals the ways in which imperialism affected colonized peoples in different ways, but led to similar results—silencing, marginalization, impoverishment, forced assimilation, and exile.

Cotera enacts an important excavation of the feminist intellectual tradition revealing that the voices of women of color are not absent as some have assumed, but instead have been neglected or silenced. Emphasizing the need to take historical specificity and social location into account, and arguing that the work of these three women contains "complex decolonizing textual subversions," Cotera further claims that "the most provocative point of connection" is each woman’s exploration of "the political and poetic possibilities of fiction." The emphasis she places on the fictional work of these women is unique, especially in the cases of Deloria and Gonzalez, neither of whose fiction was published during their lifetimes.

The book also documents the history of intellectual theft as it pertains not only to these women of color, but to the work of marginalized "others" in general. This reclamation reveals how various fields (ethnography, folklore, literature, feminism, and so on) have relied on the voices of women of color and other marginalized groups, yet have often rendered such voices invisible by using their work without giving them credit. Illuminating how gender, race, and class play key roles in this socio-historical silencing, Cotera's work speaks volumes about how vital it is to reclaim such histories.

The book is organized in two sections, with the first exploring the ethnographic and folklorist work of Deloria, Hurston, and Gonzalez, and the second considering their fictional work. The text offers a detailed account of the history, politics, and socio-cultural conditions that shaped the work of these three women while offering cogent analysis of how race, class, gender, nation, and empire informed both their work and the responses to it, and is especially useful for those interested in feminist anthropology, ethnography, folklore, and literature.

Bookending the two sections are a lengthy introduction ("Writing on the Margins of the Twentieth Century") and a concluding epilogue ("What Love Got to Do With It?: Toward a Passionate Practice"). Each of these sections are beautifully written with a comprehensive theoretical approach that teases out the complex aims of the text while offering a thorough consideration of the historical, sociocultural, and intellectual traditions shaping the work of these three authors in particular and feminist ethnographers/folklorists in general.

The epilogue is one of the most intriguing sections of the book as it covers what is so often left out in academic manuscripts—love, or what Cotera refers to as "passionate praxis." Drawing on Chela Sandoval’s idea of love as a "decolonizing practice," Cotera argues that the work of these women is both motivated by and about love. Their work is driven, she argues, by a passion for sharing and unearthing marginalized knowledge (in terms of gender and race/ethnicity). Further, their work is about the love(s) of the various peoples/characters populating their writing.

Exploring the role of women as active social agents, these women, Cotera argues, "fundamentally reorient the masculinist and colonialist direction of our collective historical imagination." Exploring what Cotera names as affinities inside differences, their work, along with that of Cotera’s, re-imagines feminist intellectual history, opening up a space for othered voices. What is not to love about that?

Written by: Professor What If, April 8th 2009

Will to Live: AIDS Therapies and the Politics of Survival

admin — Sun, 15 Jun 2008 01:39:00 +0000

By João Biehl

Princeton University Press

Ethnographers, novelists, and prisoners write heart-wrenching books because they present simple truths. Will to Live is a powerful, at points searing ethnography of HIV antibody surveillance systems in Brazil and pharmaceutical industry influence in bringing forth new relations of politics and health care. It tells of the bodily suffering of Brazilians who contract, and eventually die from, AIDS - and of those who fear such diagnoses, although they are HIV antibody negative.

It demonstrates the varying degrees of access that Brazilians have to highly active antiretroviral therapies (HAART) and that track along the fault lines of social structure. That HAART works for many (but not others) or that it comes too late (or too early or is engaged too haltingly) signifies the contradictions and paradoxes of culture and social structure that are usually revealed in epidemics. Although it is filled with positive stories and better outcomes (HAART brings many back from the brink of death), Will to Live is as painful to read as Nancy Scheper-Hughes’ Death Without Weeping, also about Brazil but in context of infant mortality; Paul Farmer’s AIDS and Accusation, also about AIDS but set in Haiti; and Begonia Aretxaga’s Shattering Silence, about Northern Ireland women who deploy their incarcerated bodies and even bodily fluids in political protest.

Will to Live shows that the national and international response to HIV and AIDS has in Brazil “shifted from controlling the epidemic to controlling individualized disease.” “Yes,” the author writes, “distribution programs make antiretroviral therapies accessible, but they are one element in the full treatment of a disease that... remains a matter of a regional politics of nonintervention.” “It’s a shame what is happening to AIDS” is the direct utterance of an otherwise well-intended caregiver, suggesting just how much the cart has been put before the horse and what the public health costs can be of imagining only a pharmaceutical response.

João Biehl is a Brazilian anthropologist and Associate Professor of Anthropology at Princeton University who has a long time studied the conceptualization, implementation and evolution of the Brazilian AIDS Control Program (BACP). Multi-sited in location, multi-method in logistics, multi-voiced in narrative, and multi-purpose in scope, Will to Live unravels and critiques the ways in which NGOs (non-governmental organizations), churches, the Ministry of Health, pharmaceutical industry representatives, gender and sex work activists, and those suffering from HIV or AIDS mounted a “national” response to HIV and AIDS that is anything but. “A central concern of my ethnography,” the author notes, “has been to produce alternative epidemiological evidence and to generate some form of visibility and accountability for the abandoned subjects with AIDS.”

A site of Biehl’s particular focus is Caasah, a part-community house, part-hospice, part-pharmacy, part-training ground in advocacy. Caasah was formed in 1992, “when a group of homeless AIDS patients, former prostitutes, transvestites, and drug users squatted in an abandoned maternity ward in the outskirts of Salvador” and turned it into a care center. He returned to Caasah in 2001 to find a near-complete turnover there of patients and staff and a reorientation of service provision and funding source. As such, Caasah well represents both the protean nature of AIDS and the constraints upon and conditions under which local-level responses to it were mounted.

All but a very few pharmaceutical industry representatives, health authorities, and politicians talk in double-speak. Many exacerbated cleavage between rich and poor, politically visible and not:

As with all things political and economic, the reality underlying the AIDS policy is convoluted, dynamic, and filled with gaps. The politicians involved in the making of the AIDS policy were consciously engaged in projects to reform the relationship between the state and society, as well as the scope of governance, as Brazil molded itself to a global market economy. One of this book’s central arguments is that on the other side of the signifier _model policy _stands a new political economy of pharmaceuticals, with international and national particularities. As NGO activism converged with state policy making, and as the public health paradigm shifted from prevention to treatment access, political rights have moved toward biologically based rights.

Comprising eight chapters including Introduction and Conclusions, Will to Live is equally heavy and light, grim and hopeful, ethnographic and theoretical. The Introduction (“A New World of Health”) bookends painful personal stories and broadly sweeping discussion of the political-economy of pharmaceuticals. Rhetorical and other slippage in the overly optimistic assessments of AIDS bureaucrats and pharmaceutical representatives is revealed in stories of busted aid posts, iatrogenic illness, and social structures that sicken people. Chapter One (“Pharmaceutical Governance”) discusses the complexities of state-local, transnational-NGO and doctor-patient relations. Biehl writes perceptively about the successes of Brazil in manufacturing generic drugs that challenged patent rights granted by the WTO.

The particular successes and failures of Caasah are scattered in discussion throughout the book, but Chapter Two (“Circuits of Care”) looks intently at the new subjectivities (e.g., patient-citizen, “risk group” member, the “worried well”) that arise in social, technical and economic relations brought to bear by HIV, HIV antibody testing and AIDS. The failures of the surveillance system – but also its tremendous promise – are shown acutely in the next chapter, “A Hidden Epidemic,” which reveals the biases in public health and society at large with regards to surveillance, treatment and counseling. Chapter Five, “Patient-Citizenship,” examines the Phoenix-like rise from the ashes of imminent death that has been occasioned in many of those who have responded particularly well to HAART. Many have resumed reasonably normal sexual and political lives relatively free of the anxieties and technoneuroses brought on by the antiretrovirals themselves and the HIV antibody testing and counseling regime. The first section of Chapter Six, “Will to Live,” is appropriately titled “Lifelong AIDS,” for it reveals the stark contours of the limits and promises of a largely biomedical “fix” for what is clearly and also about sickness in the social-structure.

There is little for a reader about which to complain. A quotation is repeated and some Index entries are incorrect, but there are extremely few typos or grammatical infelicities. I want to highlight one particular kind of problem that mars Biehl’s presentation at many points, however. Biehl claims that “Epidemiological surveillance services registered the first HIV/AIDS cases in 1982.” This conflates HIV and AIDS, as he does ad infinitum, and HIV hadn’t yet been identified, either. It doesn’t excuse him to say that everyone else does, too - for real damage is done in such conflation, for example, that “HIVab+” means a death sentence and a rhetorical slide to “AIDS” to “contagious” to social leperhood.

Moreover, “AIDS” had not yet congealed into a biomedical category, either. This leads him at many, many points to confuse cause and effect, vector and pathogen, infection and antibody, for example, when he says that “the homosexual/bisexual mode of transmission accounted for less than thirty percent of the total number of AIDS infections.” Ontologically, epidemiological notions do no counting; epidemiologists do. Logically, “bisexual” mode of transmission (of HIV) has also to mean “heterosexual,” which then must be explained anew for its expanded and more complicated, often hidden properties. Empirically, the “total number of AIDS infections” would multiply the epidemiological categories of “HIV antibody positive” and “AIDS diagnoses” by at least five-fold if not twenty-fold, that is, in terms of pulmonary tuberculosis, cryptosporidium, toxoplasmosis, pneumocystis carinii pneumonia, persistent diarrhea, anaemia, and so on. As well, this undercuts the force of Biehl’s informants who rightly point to the endemic state of such infections and problems prior to the arrival of HIV and AIDS. Further, it suggests that these individual infections or pathogens are sexually transmitted and that there are characteristic differences along the lines of sexual identity (i.e., “heterosexual” transmission of this, “homosexual” transmission of that).

The lengthy discussion of subjectivity comprising Chapter Four is difficult to follow and jargony, although its theorization of “technoneurosis” (and elsewhere, of “auto-bioadministration”) is spot-on. Biehl argues from the standpoint of careful analyses of case studies that the “confused and painful experience of Oxygen [the pseudonym of a sick and anxious woman repeatedly testing HIVab negative] was somewhat technically engineered. This testing apparatus played a determinant role in the emergence of a socially visible imaginary AIDS.”

Nevertheless, this and other chapters exemplifies well the Foucaultian thesis that discourse about subjects (in this case, about the technical aspects of an HIV antibody test and about what constitutes “good” and “bad” sex) creates new subjects: the worried well, the sick and the anxious, the promiscuous and the guilt-ridden. The algorithm of HAART adherence is predictable on sociological grounds. “Failures” are on blamed on the individual, not the system; not the social structure; not the lack of housing, food, education, and employment. Nor was the HAART roll-out so universal and stable as its proponents claimed

Laid atop an already struggling public health system, Biehl found that “the universal availability of essential medicines has been subject to changing political winds; treatments are easily stopped, and people have to seek more specialized services in the private health sector or, as many put it, ‘die waiting in overcrowded public services.” The meaning of “primary care” has changed to mean selective targeting of those more likely to live, and triage has replaced universality as a metaphor of coverage. Clients become clinical trial subjects. Treatment trumps prevention. Risk becomes individualized instead of increasingly social. Infection becomes increasingly moral and subject to religious edict. HIV antibody test counselors compete with one another not to be the one to read the positive bands. Social scientific insights are swept aside.

This newest addition to Princeton University’s (In)Formation Series, edited by Paul Rabinow, is a sober but accessible and extremely humane text, just as well constructed as attractively presented. The black-and-white photographs taken by Torben Eskerod are arresting and invite commentary, speculation and, in my case, envy. Around this exciting new work could be wrapped all manner of upper-division or graduate-level courses in anthropology, public health, medicine and even political-economy. Like too many countries and cultures to count, ill-tempered politicians, cynical epidemiologists and overburdened healthcare workers in Brazil have contributed to an official portrait of HIV transmission dynamics, infectious burden and prevention efforts that often bears little resemblance to reality. Once again, the inequalities of social structure get off scot-free. This ethnography is a major contribution to social theory and justice.

Written by: Lawrence James Hammar, Ph.D., June 14th 2008