AIDS

Passage to Manhood: Youth Migration, Heroin, and AIDS in Southwest China

tina — Fri, 25 Feb 2011 08:00:00 +0000

Heroin. AIDS. Migration. Development programs. Gender roles. In Passage to Manhood: Youth Migration, Heroin, and AIDS in Southwest China, Shao-hua Liu examines each of these issues and how they relate to Nuoso youth. An anthropological researcher, the author delves into how China’s evolution from the traditional to the modern intersects with drug use, disease, and development. The book focuses on the Nuoso, a poor and marginalized group in southwest China that has been disproportionately affected by the drug trade and HIV/AIDS.

The author does a commendable job of stressing the interconnected nature of migration, gender, drug use, and political economies. While these issues are naturally linked, too many authors focus on one of these aspects while ignoring the myriad forces that shape cultures and communities. Passage to Manhood features a fresh approach to understanding why heroin use and HIV took over the Nuoso to such a great extent. The author presents an answer that relies on the intersection of marginalization, stigmatization, modernization, and power dynamics within communities.

The author’s honest approach to gender stood out in the book. Instead of making sweeping generalizations about gender politics among the Nuoso, the author explains how she approached the subject and details the difficulties she had using male translators to interview women.

Acknowledging that her access to information was limited, the author conveys the basic framework of what she found. While drug use and HIV/AIDS shaped the entire community in some way, it affected men and women differently. The author explains that young men were first drawn to heroin because it was fashionable and demonstrated a particular social status. Drug use overlapped with the definition of masculinity among the Nuoso, which was based on a desire for adventure and mobility. The gender hierarchy, which placed women subordinate to men, played out in heroin politics: Women encountered the drug trade through small dealings and followed their husbands or partners, who were responsible for the larger trades.

The author is careful to note that gender dynamics not only shaped the details of the drug trade among the Nuoso, but also determined the effectiveness of state-managed intervention programs to combat drug use and HIV/AIDS. In a careful dissection of the failures of these intervention programs, the author examines how the program administrators viewed cultural taboos about sex as barriers to their work. Instead of acknowledging the fluidity of cultural norms, state-managed interventions overlooked honest sex education and contributed to misinformation about HIV/AIDS. By ignoring the unique cultural context of the Nuoso and using global AIDS messages from elsewhere, the architects of these programs inadvertently instilled a stigma about AIDS where one previously did not exist. This case study presents a sobering lesson for those working on global AIDS prevention programs; such interventions must be designed as a cooperative exercise between local groups and the program implementers, not cookie-cutter programs delivered from above.

It is difficult to pluck one nugget of information from the author’s interconnected web, but perhaps the greatest take away from the book is that AIDS and drug use do not exist in a vacuum. Gender politics, economics, migration, and urbanization each exact pressure on people’s actions and perceptions. A thorough understanding of drug use and HIV/AIDS within a community must begin with an expansive interpretation of how individuals, families, and societies grapple with these ever-changing forces.

Written by: Andrea Gittleman, February 25th 2011

Patrick's Wish

alicia — Thu, 04 Nov 2010 16:00:00 +0000

By Rebecca Upjohn, Karen Mitchell

Second Story Press

Patrick's Wish is a true story told from the perspective of a young girl whose brother had a serious illness. It is evident from page one that there was some serious hero worship going on when it came to her older brother, Patrick. The book itself has an almost scrapbook feel to it, with alternating pages of text and photographs from Patrick and Lyanne’s childhood, and it details Lyanne’s eventual discovery that her brother’s illness is terminal.

Patrick, a hemophiliac, contracted HIV from a blood transfusion, and while he and his parents kept this secret for many years, Patrick ultimately decided he needed to share his diagnosis with the rest of his family. As he moved through adolescence with relatively few symptoms, Patrick and his family became active in spreading the word about AIDS and raising money for medical research.

Patrick's Wish chronicles his journey as an active young man who eventually took the incredibly difficult step of educating his peers about HIV and AIDS in an effort to remove some of the stigma from those who suffer from the disease. When Patrick’s body finally succumbed to the effects of AIDS, Lyanne took up the torch and continued her brother’s work.

Patrick's Wish is aimed at children and does an admirable job of using the voice of a young girl to impart its message. Full color photographs help the reader to visualize Patrick and his family as any other family. The “hard science” of the disease itself is explained in a way that is understandable for children. I especially appreciated the HIV/AIDS facts on the last two pages of the book, which provide concrete information about the disease, its transmission, and its treatment.

My eight- and ten-year-old daughters both asked to read Patrick's Wish, which created the perfect opportunity to engage in a discussion about HIV and AIDS. The girls asked whether we knew anyone who was HIV positive and were interested to know whether their schools could benefit from presentations or special education on the disease. The book’s other merits notwithstanding, this gave us more than enough reason to read and recommend Patrick's Wish.

Written by: Kari O'Driscoll, November 4th 2010

The Other City

beth — Thu, 23 Sep 2010 02:00:00 +0000

Directed by Susan Koch

Cabin Films

Most cities are comprised of at least two distinct sub-cities, so to speak. It’s particularly appalling that Washington, D.C., the nation’s capital and symbolic of the triumph of democracy, has a higher HIV/AIDS rate than Port au Prince, Haiti or Dakar, Senegal. A one percent infection rate of a city’s population is considered an epidemic; D.C.'s can be estimated between three and five percent. While one part of the District’s population goes about the business of running the country, another goes about the business of trying to stay alive.

More than one million people in the United States are currently infected with HIV/AIDS; of those infected, one in five do not know they are infected. It is the leading cause of death for black women ages twenty-five to thirty-four. The epidemic rages on, though goes largely unnoticed outside of certain communities. The visible reminders, like public funerals and rallies that were popular in New York City in the 1980s, have largely faded from the public eye and popular discourse.

The epidemic has shifted, however. Once stereotypically attributed to men who sleep with men and drug users, the problem has largely settled over poor communities. In The Other City, the epidemic’s many D.C.-area victims and survivors are shown in a variety of situations and circumstances. Jose’s ex-boyfriend lied about being infected. Donald, who had been living in his parents’ basement, moved into the Joseph’s House hospice and thrived. Still, after more than thirty-five of his friends died, he moved out, saying, “It’s worse than war.”

J’Mia, who is twenty-eight with three kids, worries that because of the myriad legal documents needed to apply for subsidized housing—many of which she struggles to find, spending entire days making phone calls—she’ll end up on the street. If she ends up homeless, she insists that she won’t take her pills and will sleep with whoever will put a roof over her family’s heads. In the housing counseling office, she’s asked demeaning questions like “How many sex partners have you had?” Despite all of this, she speaks with authority about how women are caregivers and take care of others before themselves. Her pride and perseverance is encouraging, a hopeful ray in a dark situation.

While the stories The Other City highlights are critical, the film itself is incredibly frustrating. It shifts between narratives and profiles without helpful transitions, making it seem more like a series of vignettes about living with HIV/AIDS than an actual narrative about the epidemic in the District. Formerly incarcerated men in a support group are shown in a scene next to a hospice where AIDS patients come to die. While the theme technically holds together, the images and stories feel disjointed when presented in such a way. Shot on video, the visuals feel crude and unpolished.

As someone with a family member who has been living with HIV/AIDS since the 1980s, you would think I would be particularly drawn to this film. I was not. I appreciate what the filmmakers—many of them highly acclaimed and well respected in their field—attempted to do in telling the ignored stories of the often faceless victims of the AIDS epidemic, the problems facing needle exchange programs, and the history of mismanagement in combating the domestic epidemic. But whether the filmmakers’ efforts were hindered by class privilege or a lack of true connection to their subjects is unknown. I’m incredibly pleased that films like this one are made, but I wish they were as captivating as the subjects they feature.

Written by: Brittany Shoot, September 22nd 2010

The Blessing Next to the Wound: A Story of Art, Activism, and Transformation

admin — Wed, 18 Aug 2010 01:00:00 +0000

By Hector Aristizabal, Diane Lefer

Lantern Books

As a survivor of government sanctioned torture in Colombia, Hector Aristizabal was left with unsettled anger and fear. His wariness towards both his country and his future there worsens when one of his brothers is murdered by paramilitary soldiers. Aristizabal is eventually able to cast aside his bitterness, and find ways to aid others in their struggles by holding workshops for prisoners and victims of violence in the United States. While the dust jacket of The Blessing Next to the Wound gives the impression that it is a memoir of surviving both torture and a corrupt government, the book's focus is actually splintered. It tells many stories connected through Aristzabal’s drive to aid others set both before and after his imprisonment and torture for alleged political ties.

The Blessing Next to the Wound begins with Aristizabal aiding his pregnant girlfriend and other young women seeking an illegal abortion. While Aristizabal boastfully lists the many women he seduced throughout his life, he also offers sympathy for the plight women face in a country with limited birth control resources. This later motivates him to undergo a vasectomy following the birth of his own two children, admitting that while he may not always be faithful to his wife, he will never impregnate another woman. While Aristizabal shows himself to grow, his treatment of women is never shown to be fully resolved. As a feminist, I fruitlessly waited for this to be given some resolution during the course of the book.

Each chapter tells a different vignette from Aristizabal’s rich life experience. While this approach causes the book to lack a clear focus, and often a sense of chronology, the bits and pieces he shares from his life are nonetheless captivating and often moving. During the course of the memoir Aristizabal chronicles the hardships faced by his homosexual brother who eventually dies of AIDS, the effect of the cocaine industry on Colombia, the many human rights violations that exist in the United States, and how his theater-based therapy work aids others in places of crisis in their lives. Now and then Aristizabal will make a connection between the chapter’s experience and his time spent imprisoned and tortured; these connections serve to lessen the fragmented feel of the work.

Despite its lack of focus, The Blessing Next to the Wound offers a moving portrayal of finding inspiration and direction after surviving torture.

Written by: Adrienne Urbanski, August 17th 2010

Sin, Sex and Stigma: A Pacific Response to HIV and AIDS

admin — Mon, 12 Jul 2010 00:00:00 +0000

By Lawrence James Hammar

Sean Kingston Publishing

If you took an undergraduate course in anthropology, chances are high that you learned about the South Pacific. Notables like Margaret Mead and Bronislau Malinowski made their marks there, and it continues to be a part of the world that many think of with intrigue and wonder. Anthropologist and ethnographer Lawrence James Hammar continues on the path of many greats in Papua New Guinea, but he takes a distinctly sharp turn in his subject matter.

According to Hammar, HIV/AIDS present a problem in Papua New Guinea in a unique way. Having studied it for years, he has an incredibly passionate and firm opinion on how the country is failing its people and why. He tackles gender roles and perceptions of appropriate sexual behavior, which suggest that protected sex has no place between couples. This is precisely the problem, as HIV transmission is mainly occurring between heterosexual couples.

The current HIV/AIDS education and prevention methods fail to acknowledge Papua New Guinea’s sexual networks. The one-size-fits-all approach does not take into account the sex trade or the gross injustices that women face when it comes to expression and control over sexuality. Likewise, the pervasive influence of the Church has essentially forbidden discussion and distribution of condoms in many areas. Church leaders have gone public with anti-condom messages with blatant lies about their effectiveness and have contributed to the overall stigma of protected sex. Hammar dramatically refers to this dilemma as “Biological death versus social leperhood.” To further describe this situation, he explains the multiple interpretations of the ABC (Abstain, Be Faithful, Condoms) message. Instead of condoms, some are teaching “C” to stand for commitment or Christian values. While this alone is not objectionable, Hammar points out that this ignores the reality of what is occurring in Papua New Guinea and contributes to the overall situation of HIV/AIDS not being dealt with in a productive manner.

Hammar sounds infuriated at times in this book, and the reader cannot help but feel the same. Though this situation is replicated in other forms the world over, Hammar pounds the Papua New Guinea-specific message home: What’s being done now isn’t working and it’s harmful. In the epilogue, he finally addresses the role of the anthropologist and takes up the difficult topic of how positive change might be effected as a result of his research and findings. He acknowledges the conflicting perspectives and the respect he has for the country and its people while also setting the stage for what hopefully will lead to constructive conversation.

Overall, Sin, Sex and Stigma reads like an academic text with very few literary flourishes added for readability. Its audience is very specific, and even within that audience, some readers may have difficulty following Hammar’s writing. Though informative, the book is heavy in content and delivery, and should only be considered by those who are already interested in the topic at hand.

Written by: Shana Mattson, July 11th 2010

Fig Trees

admin — Thu, 11 Mar 2010 09:00:00 +0000

Directed by John Greyson

V Tape

It’s hard to explain Fig Trees. It’s an opera yet it's also a documentary. There’s an albino squirrel and a nun. It scrutinizes the critical circumstances of the AIDS epidemic, from the 1980s to the present day, and points out, with sharp observations, the irony of consumer-driven AIDS campaigns. The main issues addressed are the ineffectiveness of governments and the greediness of pharmaceutical companies, but popular culture is not completely innocent either.

In Fig Trees, director John Greyson documents the story of South African AIDS activist, Zackie Achmat. Greyson portrays Achman as thoughtful, creative, and most of all, brave. He went on a treatment strike and refused to take his medication because he didn’t believe it was right that he could buy life while other, less affluent people couldn’t. This is where the opera, squirrel and nun come into play; they are a fragment of the visual puzzle Greyson creates.

The way in which all of the ingredients are put together to create such poignant commentary about HIV is interesting. Fig Trees is theatrical and complex—a bit too complex for my taste. For the most part, I wasn’t entirely sure what was going on. Fig Trees is subtitled, but instead of making things easier to understand, it made them even more nonsensical. This was especially true when the screen was split into two, each side giving different sets of subtitles.

This doesn't mean that the film wasn't enjoyable. On the contrary, there were some “Aha!” moments that gave me great pleasure and other moments that made me think more deeply about the issues. This prompting of contemplation is always a good thing.

Written by: Jessica Sánchez, March 11th 2010

Infectious Ideas: U.S. Political Responses to the AIDS Crisis

admin — Wed, 10 Feb 2010 01:00:00 +0000

By Jennifer Brier

The University of North Carolina Press

From the early appearance of AIDS as deviant in conservative America in the early 1980s to a full blown global battle in the 2000s, Infectious Ideas charts the activism behind the disease and how it never once wasn’t a political problem. What readers will learn with this book is that knowledge of the disease evolved alongside activist work. The origin, treatment, and likely victims of AIDS were all unknown in the early ‘80s when gay men and Haitian immigrants began to contract HIV. As a result societal scapegoating occurred and the government all but ignored the problem. Despite this, Brier shows how gay men unified to change habits, start dialogues about safe sex, and change public health policy.

With little or no experience in the health field, many early activist groups looked to the gay liberation movement of the 1970s for inspiration. As a result, racial and class discrepancies appeared as activist researchers began to realize that the highest at-risk groups were poor men of color who didn’t necessarily identify with the gay and lesbian community. San Fransisco activists worked to overcome what Brier calls “imperialism of expertise” by changing their campaigns to appeal to Latino and Black communities. Altering their way of thinking of how AIDS affects people proved vital for the moment and future efforts of global activists.

While modifying their approaches, American activists were also fighting another battle. Until the late 1980s they were essentially doing what the federal government should have been doing: informing people, promoting healthy prevention habits and working towards a treatment. However, ideological differences with the Reagan administration kept them from gaining governmental support. Instead of listening to activists with four years experience fighting the disease, the government was persuaded by internal politicians who didn’t condone condoms but rather (shockingly) chastity, fidelity and sex within marriage.

Brier positively notes that the lack of governmental support allowed for other groups to grow in more innovative arenas. She credits the Ford Foundation with raising awareness that AIDS was not simply a disease affecting gay and immigrants populations, but one that affected impoverished women in developing countries. During the late 1980s and early 1990s, the Ford Foundation focused on efforts in Brazil, Haiti, Thailand and Africa. They maintained a clear mission to “make woman’s rights human rights”. Three of the four countries that received the most funding saw significant drops in the number of new cases of AIDS.

The foundation's work strengthened the relationship between the Northern, developed world and the Southern, impoverished one. It also showed that attention to women’s rights, fighting poverty, and facing health issues overall is the most effective approach to prevent the spread of AIDS. As research continued to find medication to treat the disease, activists in the United States began to fight large pharmaceutical companies for affordable access to treatment, most notably through the work of ACT UP. Eventually disbanding due to internal problems, the group had five short but potent years which completely changed the U.S. response to drug testing and availability of medication.

Brier provides a unique account of the initial social response to AIDS in the 1980s and how it often preceded any political answers—a trend that continued into the early 1990s and today. Her book shows how we have arrived to where we are today in the fight against AIDS and what we can learn from the battles of the past.

Written by: Sara Custer, February 9th 2010

Missing Bodies: The Politics of Visibility

admin — Fri, 30 Oct 2009 23:59:00 +0000

By Monica J. Casper, Lisa Jean Moore

New York University Press

It is hard to deny the creeping, theatrical aspect that seems to permeate every mode of information and method of exposure we are subjected to daily. While once relegated to advertisements, television, and movies, the careful craft of showcasing and presenting certain bodies is now seen in governments, military, and the health industry. Why some bodies are overexposed while others are seemingly non-existent is useful in determining the underpinnings of American society and agenda. Monica Casper and Lisa Jena Moore explore these politics behind the visibility of certain bodies in Missing Bodies: The Politics of Visibility.

Upon first thought, this book might appear to be a critique of the media, a poignant peek into the ways in which the use of stereotype highlights certain bodies at the expense of others—but that topic is one that is otherwise understood, and largely written about. Casper and Moore delve deeper than that. They are concerned with the bodies that appear and disappear in much less talked about fields, such as female soldiers, people living and dying with HIV/AIDS, and infant mortality. With almost the same tools the media use to derive entertainment from everyday life, political institutions are doing the same to real lives and human suffering—and with graver consequences. The bodies of dead infants, those stricken with AIDS, and female soldiers are masked by numbers, lies, and underreporting. So how do real care, understanding, healing, and prevention begin when those bodies are erased in the first place?

At the root of the analysis is the preservation of Western ideals and agendas. By switching the concern of HIV/AIDS from a public health crisis to statistical, epidemiological data that helps manage government and secure the status of the state, there is a displacement of pain, suffering and death. The public has a harder time envisioning real people living with this disease amidst the quantitative numbers than they do erroneously understanding that HIV/AIDS is more of a disease that plagues other nations. Similarly, framing the release story of Jessica Lynch, a female prisoner of war in Iraq, as one of feminine passivity and rescue bolsters America’s dependency on gender dichotomies which fuels wars. While Lynch’s story is ultimately lost and retold as untrue, Lynch herself, and other female soldiers that suffer sexual discrimination are rendered invisible.

Lyrical, engaging, and encompassing, this book raises important and timely questions about the construction of identity and visibility in a post-9/11 landscape. In this fast-paced, technological world, others will readily construct our stories before us for benefits that are not our own. This book urges readers to question the sources, framing, methods, and presentation of information and tragedy so that we may recover the truth behind missing bodies.

Written by: Krista Ciminera, October 30th 2009

Hiding in Hip Hop: On The Down Low in the Entertainment Industry—From Music to Hollywood

admin — Wed, 28 Oct 2009 16:09:00 +0000

By Terrance Dean

Atria Books

Terrance Dean opens his book, Hiding in Hip Hop, with two quotes, one from Ellen Degeneres, in which she states, “If it weren’t for blacks, Jews, and gays, there would be no Oscars.” The other was from The Bhagavad Gita: “It is better to live your own destiny imperfectly than to live an imitation of somebody else’s life with perfection.” With so many ways to approach this book, the latter quote is the way in which I chose to do so.

Dean gives a personal account of the trials, tragedies, and triumphs of growing up as a gay Black man, inside a world that adamantly refuses to accept his existence. Things would be tragic enough if, on the quest for a healthy identity, one had to sift out the sickness of a drug-abusing mother who, along with two brothers, dies of AIDS. A forced and self-imposed separation from family, and the discovery of a sexuality not approved of by the proverbial church that houses wolves in sheep’s clothing, add to experiences that have forced others to become a statistic.

As the title of the book suggests, Dean’s passion for hip-hop propelled him to pursue a career in an environment where his sexuality is like an oxymoron. Dean still adheres to the code of maintaining a “tell and be killed” secrecy in addressing those who are queer, respected, and revered in the hip hop world. In a world where even a hint of being gay can relegate one to lifelong ostracism, Dean is careful to play by the rules and still tell his story with brute and poignant honesty.

The Degeneres’ quote that opens the book is important because she acknowledges not only the contributions made by a group she belongs to, but also those made by two groups to which she does not. It is important because there needs to be the realization that the greatest contributions to society are not defined by sexuality. If there’s a cure for cancer, how many of you will refuse it because you don’t approve of the curer’s sexuality?

The second quote Dean used discussed living one’s own life, not that of someone else. He revealed how difficult it was to hide his sexuality, his desire to openly express his love for another man, and be fully embraced by a culture to which he so profoundly contributed. He perfected the imitation of a straight man at the cost of his spiritual, emotional, and physical well-being. By the book ended, although still healing from these issues, Dean is now unapologetically choosing to work on the perfection of his own life.

Written by: Olupero R. Aiyenimelo, October 28th 2009

Moral Panics, Sex Panics: Fear and the Fight over Sexual Rights

admin — Sun, 11 Oct 2009 09:12:00 +0000

Edited by Gilbert Herdt

New York University Press

The war on drugs. The down low. Rainbow parties. Obamacare death panels. Our society has a crazy way of taking contemporary moral issues and, with a dash of religious fervor and moral superiority and a pinch of media dramatization, blowing them up into large-scale panics.

It’s not surprising that many moral panics are aimed at sexualities or sexual practices deemed “abnormal.” Moral Panics, Sex Panics: Fear and the Fight over Sexual Rights asserts that this focus on sexuality isn’t a coincidence: many moral panics are rooted in the fear that “different” sexual practices will alter the foundation of society in ways that are catastrophically devastating. Society, ever vigilant, attempts to eliminate these threats with a shrill moral anger designed to shame those outside the norm and intimidate everyone else into staying inside the bubble of conformity.

Herdt’s book suggests that this shame is not only misplaced, but also counterproductive. Often, moral panics allow communities to ignore aspects of society that are lacking or failing, and point the finger of blame at those who bear the brunt of those inadequacies. For example, Cathy Cohen’s “Black Sexuality, Indigenous Moral Panics, and Respectability: From Bill Cosby to the Down Low” suggests that the decline of the black family postulated by Cosby and others is less a product of declining moral values in black society, and more a product of societal forces that have caused economic and social justice to stagnate.

I wish I could say Moral Panics, Sex Panics captured my attention from cover to cover. Unfortunately, the book’s tendency to belabor its points meant that, only pages into a chapter, I was tempted to skip ahead a few pages or take a snooze. The chapter on gay marriage, for instance, is too heavy-handed on historical details. Analysis and discussion about those details, however, is slim, creating a book that is dry and laborious to read. Which is a shame, because Herdt’s anthology discusses a diverse array of sex panics surrounding the AIDS epidemic, black sexuality, gay marriage, reproductive rights, and colonialism—a cornucopia of issues certainly worthy of intelligent debate.

Written by: Gwen Emmons, October 11th 2009

Call Me Ahab

admin — Thu, 16 Jul 2009 09:05:00 +0000

By Anne Finger

University of Nebraska Press

Anne Finger’s award-winning Call Me Ahab showcases a plethora of historical and literary characters—each of whom is in some way disabled—and imagines new scenarios for their lives. It’s an exciting concept and while several of the stories in the nine-story collection left me cold, Finger is to be lauded for her originality.

Her talent is particularly vivid in "Vincent." Here, Finger brings Vincent Van Gogh into the late twentieth century. Instead of brother Theo endlessly supporting his deranged, if talented, sibling, he cuts him off, leaving Vincent to fend for himself on the teeming streets of New York City. Vincent’s heartbreaking existence is juxtaposed with that of a young, male bureaucrat employed by the Social Security Administration. The pairing is better than a social science text on service delivery, poignantly demonstrating the system’s betrayal of them both.

"Gloucester" re-imagines King Lear, but this time through the contemporary eyes of Gloucester Barrows, a middle-aged man dying of AIDS. Although Barrows is from a prominent political family—think the Kennedy or Bush clans—his marriage dissolved when his wife-of-convenience divorced him following his diagnosis. Now blind, Gloucester is eager to settle his affairs and has no choice but to rely on his two sons. Dexter, the elder, is pursuing elected office and has little time for his ailing dad; Charlie, just twenty, is a hippie’s hippie who has renounced material privilege to live in horrifying squalor. Gloucester’s navigation of this rocky terrain is pitch perfect and emotionally riveting.

"The Blind Marksman" takes readers into a mock socialist dystopia under the rule of “the Great Pilot of Our People, the Beacon of Hope to the Proletarians of the World, the Heroic Leader of the Struggle Against the Fascist Invader,” and introduces a blind marksman whose one-time feat with a bow-and-arrow is embellished with each telling. Like the children’s game of “telephone,” the story becomes more and more absurd, until in the end regime change renders the marksman a caricature of his former self.

The story implies that socialism is no better at protecting individuals than capitalism. But is this true? Call Me Ahab, winner of the Prairie Schooner Book Prize in Fiction, is full of questions and what-ifs. For example, what if Moby Dick was told from Ahab’s perspective? What might Helen Keller and Frida Kahlo have discussed if they’d met? Finger’s "Helen and Frida" presents a bawdy conversation between the two that will leave you reeling, grinning, or both. Other stories feature those whose perspectives are not typically considered—the dwarf in painter Velasquez’ Las Meninas; a Jewish artist commissioned to draw disfigured internees for Hitler’s medics; and feeble-minded Ned Lud, the man behind the anti-machine Luddite Rebellion, among them.

Throughout, there’s attention to the Holocaust, anti-Semitism, sexism, racism, and discrimination against people with disabilities. While message is never sacrificed to craft, Finger wants readers to appreciate the contributions made by those with physical and psychological limitations. “Who is our greatest poet after Mr. Shakespeare?” she asks. “Why blind John Milton. And in my own century of origin, Monsieur Proust was by his asthma-laden lungs impaired in a major life function… I could mention fit-shaken Van Gogh, dwarf Toulouse-Lautrec, and mad Miss Woolf…Look to the signing of the Declaration of Independence. What see you? A one-legged man, and another who adds a palsied scrawl. Who raised the nation up from the depths of the Depression? Why a man with a pair of legs like cooked spaghetti.”

World affairs and letters have clearly benefited from the talents of the disabled. But Call Me Ahab is no diatribe. Instead, it is a cheering section for the forgotten and under-appreciated and a testament to creativity, whimsy, and intellect.

Written by: Eleanor J. Bader, July 16th 2009

Tapologo

admin — Thu, 25 Jun 2009 23:34:00 +0000

Directed by Gabriella Gutierrez Dewar, Sally Gutierrez Dewar

Tapologo is a full-length documentary shot in Northwest Province, South Africa. Directors Gabriella and Sally Gutierrez Dewar chronicle a handful of the 20,000 displaced African refugees in a squatter camp called Freedom Park. Here we are exposed to life and death in a place where fifty percent of the women are infected with HIV.

The film is divided into two parts. Part one opens inside the shack of an emaciated woman receiving care from two local nurses. The woman is dying from Tuberculosis, and for a moment she glances directly into the camera lens with brown eyes that appear to have lost all innocence and hope. As we get to know other patients and nurses who inhabit the park, we see that most of the women have slept with men for money, many have contracted HIV, yet only some are receiving anti-retroviral treatment. All of them are either dying or fighting to survive. Personal accounts from the women are interlaced with stunning visual images that are both emotional and relevant, and the intensity never lets up.

The second part begins with desolate music by Joel Assaizky and shots of people walking across train tracks, sitting on sides of roads, just standing around watching each other. This time is spent contextualizing the squalor of Freedom Park in the apartheid aftermath. In a place where the alternative to starvation is sexual exploitation, it’s impossible to ignore the political history.

Then we learn about Tapologo, a collective of female caregivers who self-organize and treat the hopelessness of their immediate surroundings. Before this network existed, individuals were left alone with their chronic diseases as poverty and pain devoured them. Now these strong women, many of them diagnosed with HIV themselves, have begun to administer anti-retroviral treatment and provide bedside and hospice care. As a result, a community has begun to form, and with the help of Brother Joe, Sister Georgina, and bishop Kevin Dowling (Catholic community leaders and activists who share relatively progressive ideology), Tapologo has begun to break Freedom Park's cycle of poverty, patriarchy and an overall loss of dignity.

One scene in particular illustrates the spirit of this film. A nurse named Thimbi (a former sex-worker and HIV victim) pays a visit to the shack of a helpless woman and her infant. She says confidently, "Filth can make the illness worse," and begins to wash dishes and floors on her hands and knees. For Thimbi and others, volunteering with Tapologo gave them a chance to believe in themselves, to find beauty within, and to be proud of life's small victories. This moment, and this film, is a great reminder to step out of our daily comforts and confront real issues facing real women.

Written by: Katy Pine, June 25th 2009

Anthropology and Public Health: Bridging Differences in Culture and Society, Second Edition

admin — Fri, 08 May 2009 11:49:00 +0000

Edited by Robert A. Hahn, Marcia C. Inhorn

Oxford University Press

With the space allotted, I couldn’t render the titles and names of the fifty-some authors of the twenty-five chapters that make up this exciting collection. It is called a second edition of the earlier volume edited by Robert Hahn, but it is entirely new. It overlaps only by the still-compelling final chapter, George Foster’s 1987 critique of international health bureaucracies (which I read in grad school). Each new contribution is clear and accessible, founded upon ethnographic study, and informed by multiple theoretical developments. Each is as depressing to read as is the state of global health...and just as hopeful.

The editors selected these contributions carefully and arranged them into four broad sections: anthropological understandings of public health problems; anthropological designs of public health interventions; anthropological evaluations of public health initiatives; and anthropological critiques of public health policy. The editors’ introduction implicitly explains the purpose and scope of the book and the treble entendre of the change from Anthropology in Public Health to _Anthropology and Public Health. Much has changed in a decade. Owing to new public health crises and resurgence of old ones, anthropological research methods and ethnographic insights about health, wealth, suffering, and sickness are dining at the policy table as never before.

There’s no sense trying to pick favorites from two dozen highly polished essays. If I highlight four, it is only to suggest the range, scholarship, and humanity of the entire volume. Eric Stein’s “’Sanitary Makeshifts’ and the Stratification of Health in Indonesia” is a first-rate contribution to “toilet studies,” to the political economy of human waste, the other end, as it were, of “Development.” I could have written Mark Padilla’s essay, “The Limits of ‘Heterosexual AIDS,'” so close to my thoughts was his ringing critique of heteronormativity in studies of HIVab seroprevalence. The provocative chapter by Inhorn, Kobeissi, Abu-Musa, Awwad, Fakih, Hammoud, Hannoun, Lakkis and Nassar, “Male Infertility and Consanguinity in Lebanon,” probes the genetic and physiological outcomes of social preferences for marriages between genealogically close relatives. As with STDs made the more resistant by antibiotics, some outcomes are made worse by the Western technology of intracytoplasmic sperm injection, which can reproduce male infertility. Karen Moland and Astrid Blystad’s essay made me cry and think of infected mothers everywhere. “Counting on Mother’s Love: The Global Politics of Prevention of Mother-to-Child Transmission of HIV in Eastern Africa” is best essay I’ve read in years.

Anthropology and Public Health will remain the standard of collaboration and reportage for a long time. Around it could be wrapped upper-division undergraduate courses in medical anthropology and sociology, just as it could anchor graduate-level seminars in anthropology, public health, and maybe even epidemiology. Each essay is first-rate.

Written by: Lawrence James Hammar, Ph.D., May 8th 2009

Cocoa Butter Body Cream: Vanilla Mocha

admin — Thu, 19 Mar 2009 23:58:00 +0000

By Alaffia

I love my organs! My kidneys are awesome. As bad as I have been to my liver, it has never let me down. My heart is a hard-working love machine. Although, I must say, my absolute favorite organ has to be my skin, and the best part is that I have lots of it!

My skin has been so good to me, I am certainly grateful that, even after years of long baby oil tanning sessions, it still appears mildly even-colored, and I haven’t attained that proverbial fried-pork-rind look. Still, something tells me that I should start taking better care of it, and that something is my brain, the organ that keeps the others alive, so I probably should listen.

As much as I like slathering my epidermis in an artificially perfumed mixture of aluminum starch octenylsuccinate, dimethiconol, threonine, and propylparaben, it might finally be time for me to start being able to pronounce whatever it is that is going into my still not-so-enlarged pores. And that’s why I’m really excited about Alaffia's Vanilla Mocha-scented Cocoa Butter Body Cream. With a little more than cocoa, shea butter, and vanilla extract, Alaffia has made a magical frosting that leaves my skin soft, not greasy, and smelling so much like a birthday cake that I am afraid to stay in a yoga pose for too long for fear that my classmates will take a bite out of me.

Alaffia is a Fair Trade co-op based partly in Olympia, WA, and partly in Togo, Africa (hometown of founder Olowo-n’djo Tchala). Togo provides the most basic of Alaffia's ingredients: shea butter. The West African members of the cooperative benefit by applying their knowledge of traditionally handcrafting the shea butter to make a fair wage, and since shea trees grow wild and are a renewable resource, it is also ecologically safe for their community. I also think it is important to mention that ten percent of all sales go directly to community enhancement projects in both West Africa and the state of Washington.

Besides the body cream, Alaffia creates lotions, soaps, shampoos, conditioners, and other products—all of which are available on their website at alaffia.com. Now, if someone can come up with a better product-benefit combination of having eco-friendly, soft legs and raising AIDS awareness while providing medical and school supplies to African communities, please let me know!

Written by: Laura Koffler, March 19th 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