Topics in Anthropology:
HIV/AIDS in Africa (and the Diaspora)
AFAS/Anthro 313
Eliot 314, TuTh 11:30-1:00
Prof. Shanti Parikh
Washington University, Spring 2001
Tel: 935-7887
Email: sparikh@artsci.wustl.edu
Africa's first HIV/AIDS billboard, built in 1986 outside of Kampala, Uganda.
Course Description:
This seminar examines HIV/AIDS in Africa and the Diaspora through historical, social, political, and epidemiological lenses. Students will engage with a variety of analytic approaches and explanatory models for understanding the complex and myriad effects, responses, conditions, hierarchies, histories and debates surrounding the AIDS crisis. The course emphasizes the ethnographic approach as a tool for researching and representing how local communities comprehend and deal with the deadly viral infection. Attention will be given to the relationship between local communities and wider historical and economic processes, such as the politics of representation and global inequalities of health care, gender and race. Other topics covered in the seminar include the cultural construction of AIDS, risk and disease(d); government responses to AIDS; origin and transmission debates; ethics and responsibilities; the making of the AIDS industry and “risk” categories; prevention and education strategies; interaction between Western medical practices and African healing systems; and medical advances and hopes. This is an intensive reading and writing course.
Background:
AIDS emerged onto the public health agenda in 1981/2 and quickly became a global problem of historic dimensions. The epidemic is a complex social and political as well as medical phenomena, invoking different interpretations and responses depending on the region(s) and players involved. Throughout the world, the viral infection disproportionately affects poor people and black people. According to United Nations AIDS commission (UNAIDS), today sub-Saharan Africa accounts for nearly 70 percent of global HIV cases. Within the U.S., the Center for Disease Control (CDC) estimates that black Americans comprise of 55 percent of the nation's total HIV population. Numbers, however, tell only a partial, often disputed, and sometimes distorted story. They also tend to obscure, mask, or silence other equally valid perspectives and counter-hegemonic narratives. This course equips students with interdisciplinary and multi-level approaches for critically understanding how AIDS operates within certain social and economic contexts, and how individuals and communities have dealt with disease(d) over the last twenty years.
Course Assignments and Grading:
Class participation (15%): The format of the seminar is discussion, short lectures, and small group activities. Students are expected to critically read and actively participate in class. Repeated absence, tardiness, and lack of participation will result in a lower grade. Students are strongly encouraged to meet with the professor at least two times during the semester to discuss their progress on course assignments.
Short assignments (25%): There will be several short assignments in which students will apply recently discussed theories to primary materials or find articles and other data related to the week's theme. In the first assignment, due Tuesday January 23rd, students will use cultural theory to analyze how the New York Times portrayed comments made by South African President Thabo Mbeki in which he allegedly questioned the dominant idea that HIV is the sole cause of AIDS.
Response papers (20%): Students will write two 4-5 page response papers to weekly readings, due Wednesday of that week. Response papers should include the following: (1) a brief summary of each author's thesis, evidence, arguments, and conclusions; (2) a synthesis of the week's readings, including a comparison of authors' arguments and approaches, a discussion of overriding themes and issues, and comments on the implications of such inquiries, and (3) questions for class discussion. Students are expected to assist in leading the class discussion the weeks of their response papers.
Research project (10%): Students will deliver a fifteen-minute presentation on a research topic of their choice that has been approved by the professor. In addition to materials from class, students will gather information from academic journals, global health agencies, advocacy groups, policy-makers, and popular media. Students are also encouraged to gather material from online African newspaper. Some of these sources can be accessed via the Internet (see the course web page for a listing) and students are expected to be actively involved in identifying other sources.
Ethnographic analysis (25%): Students will write two 5-8 page critical essays about the three ethnographies read in this course. In addition to summarizing and comparing each author's field methods, thesis, and explanatory models students should use the analytic tools discussed in class to critically examine the different conceptual frameworks, arguments, and implications of the ethnographies. The first essay (10%) is due Thursday March 8th and the second (15%) is due April 6th.
Note on all written assignments: Late assignments will be marked down. Paper style guidelines and citations for references should follow those outlined by the American Anthropological Association (found at: http://www.aaanet.org/style_guide.htm). Students are expected to adhere to the University's academic integrity and plagiarism policies.
Links to Internet AIDS Information Sites: On Course Web Page
On Reserve: Various books on Africa and AIDS are on reserve at Olin Library, including most of the required texts.
Course Materials:
Books (available at the campus bookstore)
African novels:
· Macgoye, Marjorie. 1997. Chira. East African Educational Publishers.
· Geteria, Wamugunda. 1992. Nice People. East African Educational Publishers.
Ethnographies and collected essays:
· Bond, George; Kreniske, John; Susser, Ida; and Vincent, Joan. 1997. AIDS in Africa and the Caribbean. Boulder: Westview Press.
· Farmer, Paul. 1992. AIDS and Accusation: Haiti and the Geography of Blame. Berkeley: University of California Press.
· Setel, Philip. 1999. A Plague of Paradoxes: AIDS, Culture, and Demography in Northern Tanzania. Chicago: University of Chicago Press.
· Sobo, Elisa. 1995. Choosing Unsafe Sex: AIDS-Risk Denial among Disadvantaged Women. Philadelphia: University of Pennsylvania Press. Read chapters
Optional:
· Cohen, Cathy. 1999. The Boundaries of Blackness: AIDS and the Breakdown of Black Politics. New Haven: Yale Press.
· Farmer, Paul. 1999. Infections and Inequalities. Berkeley: University of California Press.
· Garrett, Laurie. 1994. The Coming Plague: Newly Emerging Diseases in a World Out of Balance. NY: Penguin Books
· Garrett, Laurie. 2000. Betrayal of Trust: The Collapse of Global Public Health. NY: Hyperion.
Articles:
· Readings available at Hi-Tech Copy and at the library reserve desk.
Films (viewed in class and on-reserve)
· And the Band Played on, based on Randy Shilt’s book
· AIDS in Africa
· Everyone’s Child
· Femmes aux yeux Ouverts (Women with Open Eyes)
Course Schedule and Themes:
Week 1: Cultural Theory & Western Representations of AIDS in Africa
January 16 & 18
January 16
Introduction
January 18
Treichler, Paula. 1999. “AIDS and HIV Infection in the Third World: A First World Chronicle.” In Treichler (ed) How to Have Theory in an Epidemic. Durham: Duke University Press. pp. 99-126.
Cohen, Cathy. 1999. “All the Black People Fit to Print.” In Cohen’s The Boundaries of Blackness: AIDS and the Breakdown of Black Politics. New Haven: Yale. pp. 149-185.
New York Times articles on South African President Thabo Mbeki’s comments on AIDS.
http://www.nytimes.com/library/national/science/aids/aids-index.html
Recommended:
Harrison-Chrimuuta, R. and Chirimuuta, R. 1997. “AIDS from Africa: A Case of Racism or Science?” In AIDS in Africa and the Caribbean. Oxford: Westville Press. pp. 165-180.
Week 2: The mid-1980s & The “Emergence” of AIDS
January 23 & 25
January 23
Garrett, Laurie. 1994. “Hatari: Vinidogodogo (Danger: A Very Little Thing)” In The Coming Plague: Newly Emerging Diseases in a World Out of Balance. NY: Penguin Books. pp 281-381. (Read 281-341).
Video—And the Band Played On, library room 252.
Due January 23: Assignment--Mbeki in the U.S. Media: A Critical Analysis of Language, Representation, and Power. (4-6 pages, double-spaced, 12 pt font, 1” margins)
January 25
Garrett, Laurie. Finish reading “Hatari.” pp. 342-381.
Supplemental Readings
Fine, Gary Alan. 1992. “Welcome to the World of AIDS: Fantasies of Female Revenge.” In Fine’s Manufacturing Tales: Sex and Money in Contemporary Legends. Knoxville: U of Tennessee Press. pp. 69-75.
Goldstein, Diane. 1992. “Welcome to the Mainland, Welcome to the World of AIDS: Cultural Viability, Localization and Contemporary Legend.” In Contemporary Legend, 2, 23-40.
Grmek, Mirko. 1990. History of AIDS: Emergence and Origin of a Modern Pandemic. Princeton: Princeton Press.
Week 3: The African Context—Culture, Society, and Economy
January 30 & February 1
January30
Macgoye, Marjorie. 1997. Chira.
Supplemental Reading
Washington Post article about AIDS and Chira in western Kenya, “ Disease Spread Faster Than the Word.”
http://www.washingtonpost.com/wp-dyn/articles/A58203-2000Jul6.html
February 1
AIDS in Africa and the Caribbean.
Chapter 2—Anne Akeroyd. “Sociocultural Aspects of AIDS in Africa: Occupational and Gender Issues.” pp. 11-30.
Week 4: Anthropological Approaches to AIDS
February 6 & 8
February 6
AIDS in Africa and the Caribbean.
Chapter 1—Bond, Kreniske, Susser, and Vincent. “The Anthropology of AIDS in Africa and the Caribbean.” pp. 3-9.
Chapter 6—Bond and Vincent. “AIDS in Uganda: The First Decade.” pp. 85-97.
Video—AIDS in Africa, Library room 252
February 8
Parker, Richard. 1995. “The Social and Cultural Construction of Sexual Risk, or How to Have (Sex) Research in an Epidemic.” In Culture and Sexual Risk: Anthropological Perspectives on AIDS. Amsterdam: Gordon and Breach Publishers. pp. 257-270.
Schoepf, Brooke. 1995. “Culture, Sex Research, and AIDS Prevention in Africa.” In Culture and Sexual Risk: Anthropological Perspectives on AIDS, (eds) H. ten Brummelhuis and G. Herdt. Gordon and Breach Publishers. pp. 29-51.
Supplemental Text
Herdt, Gilbert and Lindenbaum, Shirley (eds). 1992. The Time of AIDS: Social Analysis, Theory, and Method. Newbury Park: Sage Publications.
Week 5: Critical Theory & Political Economy
February 13 & 15
February 13
Singer, Merrill. 1998. “Forging a Political Economy of AIDS.” In The Political Economy of AIDS, Singer (ed). NY: Baywood Publishing. pp. 3-31
Roseberry, William. 1998. “Political Economy and Social Fields.” In Building a New Biocultural Synthesis: Political-Economic Perspectives on Human Biology. (eds) Alan Goodman and Thomas Leatherman. Ann Arbor: U of Michigan Press. pp. 75-92.
AIDS in Africa and the Caribbean.
Chapter 9—Maryinez Lyons. 1997. “The Point of View: Perspectives on AIDS.” In AIDS in Africa and the Caribbean. pp. 131-148.
Guest Speaker: Prof. Brad Stoner (PhD Anthropology & MD). “The Biomedical Basics of HIV/AIDS: History, Advances, and Uncertainties.”
February 15
Callanhan, Byran and Bond, Vincent. 1999. “The Social, Cultural, and Epidemiological History of Sexually Transmitted Diseases in Zambia.” In Histories of STDs and HIV/AIDS in Sub-Saharan Africa, (ed) P. Setel. CT: Greenwood Press. pp. 167-193.
Cohen, Cathy. 1999. Chapter 1: “The Boundaries of Black Politics.” In Cohen’s The Boundaries of Blackness: AIDS and the Breakdown of Black Politics. New Haven: Yale Press. pp. 1-32.
Parikh, Shanti. 2000. ”’You Mix up My Chemicals Wrongly’: The Poetics, Politics and Violence of Youth Sexuality.” From Parikh’s Desire, Romance, and Regulation: Youth Sexuality in Uganda’s Time of AIDS. Dissertation, Anthropology Department, Yale University.
Recommended
Geshekter, Charles. 1995. “Outbreak? AIDS, Africa and the Medicalization of Poverty.” In Transitions 5(3):4-14.
Geshekter’s responses to criticism of his thesis and data.
Week 6: Ethnographic Study #1 (USA): Risk, Denial, and Love
February 20 & 22
February 20
Sobo, Elisa. 1995. Choosing Unsafe Sex: AIDS-Risk Denial among Disadvantaged Women. Philadelphia: University of Pennsylavania Press. Read selected chapters.
Guest Speakers:
Clinical AIDS practitioner from a public St. Louis STD & AIDS clinic and an OBGYN/Women’s Health specialist.
February 22
Sobo’s Choosing Unsafe Sex. Read selected chapters.
Recommended
AIDS in Africa and the Caribbean.
Chapter 8—Regina McNamara. 1997. “Female Genital Health and Risk of HIV Transmission.”
Week 7: Ethnographic Study #2 (Haiti): Histories, Blame, and Poverty
February 27 & March 1
February 27
Farmer, Paul. 1992. AIDS and Accusation: Haiti and the Geography of Blame. Berkeley: University of California Press. Read selected chapters.
March 1
Farmer’s AIDS and Accusations. Read selected chapters.
Supplemental Reading
Farmer, Paul. 1999. Infections and Inequalities. Berkeley: University of California Press.
Week 8: Discussion—Ethnographic Approaches to AIDS
March 6 & March 8
March 6 & 8
Finish reading either Sobo’s or Farmer’s ethnography, depending on their area of interest and with approval of the professor.
Due March 8: Critical analysis of ethnographies, focusing primarily on either Sobo or Farmer. 5-7 pages (double-spaced, 12 pt font, 1” margins).
Week 9: Spring Break
March 13 & 15
Enjoy!
Week 10: The “African Sexuality Model” Debate
March 20 & 22
March 20
Caldwell, John et al. 1989. “The Social Context of AIDS in Sub-Saharan Africa.” In Population & Development Review, 15(2): 185-234. (skim,read pp. 194-216 & 222-227)
March 22
Ahlberg, Beth. 1994. “Is there a distinct African Sexuality? A Critical Response to Caldwell et al.” In Africa 64: 220-42.
Heald, Suzette. 1999 [1995]. “The Power of Sex: Reflections on the Caldwell’s ‘African Sexuality’ Thesis.” In Heald’s Manhood and Morality: Sex, Violence and Ritual in Gisu Society. New York: Routledge.
Le Blanc, Marie-Nathalie; Meintel, Deirdre; and Pichė, Victor. 1991. “The African Sexual System: Comment on Caldwell et. al.” In Population and Development Review, vol. 17, no. 3, September. pp 497-505.
Caldwell, John; Caldwell, Pat; and Quiggin, Pat. 1991. “The African Sexual System: Reply to Le Blanc et.al.” In Pop. and Develop. Review, vol. 17, no. 3, September. pp 506-515.
Week 11: Ethnographic Study #3 (Tanzania): Migration, Urbanization, and Changing Sexual Landscapes
March 27 & 29
March 27
Setel, Philip. 1999. A Plague of Paradoxes: AIDS, Culture, and Demography in Northern Tanzania. Chicago: University of Chicago Press. Read Chapt 1, 2, & part of 3; pp. 1-78.
Video—Everyone’s Child, Library room 252.
March 29
Setel’s A Plague of Paradoxes. Chapters 3-5; pp. 78-143.
Week 12: Ethnographic Study #3 (Continued): Hope, Desire, and Contagion
April 3 & 5
April 3
Setel’s A Plague of Paradoxes. Chapters 5-7; pp. 144-249.
April 5
Finish Setel’s A Plague of Paradoxes.
Video— Femmes aux yeux Ouverts (Women with Open Eyes), library room 252.
Due by 5:00pm: Critical analysis of Setel, with a discussion comparing the three ethnographies read in this course. 6-8 pages (double-spaced, 12 pt font, 1” margins)
Week 13: Prevention, Development, and Indigenous Healing Systems
April 10 & 12
April 10
Students will:
· research prevention models on using internet resources and academic journals
· select and read one case study (by Susser and Kreniske, Santana, or Bond and Vincent) on prevention programs from AIDS in Africa and the Caribbean.
AIDS in Africa and the Caribbean.
Chapter 10—Reid, Elizabeth. “The HIV Epidemic as a Development Issue.” pp. 149-158.
Guest Speaker: Karen Kroger, PhD. (STD Prevention Fellow, Washington University School of Medicine, Division of Infectious Diseases).
April 12
Green, Edward. 1999. (excerpts from) Indigenous Theories of Contagion. London: Sage.
Supplemental Reading
Bolton, Ralph and Singer, Merrill. 1992. Rethinking AIDS Prevention: Cultural Approaches. Gordon and Breach Publishers.
Week 14: Policies, Human Rights, and Medical Ethics
April 17 & 19
April 17
AIDS in Africa and the Caribbean
Chapter 13—Turshen, Meredeth. “U.S. Aids to AIDS in Africa.” pp. 181-190.
Scheper-Hughes, Nancy. 1994. “An Essay: AIDS and the Social Body.” In Social Science and Medicine (39) 991-1003.
April 19
Rothman, David. November 30, 2000. “The Shame of Medical Research.” In NY Times Book Review. http://www.nybooks.com/nyrev/WWWarchdisplay.cgi?20001130060F
Supplemental Reading
Schoofs, Mark. 1999. “Ending the Epidemic: Prostitutes and AIDS Vaccine Testing.” In The Village Voice. http://www.villagevoice.com/issues/9950/schoofs.shtml
Feldman, Douglas (ed). 1994. Global AIDS Policy. Westport, CT: Bergin & Garvey.
April 24
Week 15: The Future of AIDS
April 24 & 26
Readings TBA. Group presentations
April 26
Final comments, thoughts, and course evaluations.
Tuesday May 1st: Final Project Due
Late assignments will be marked down
