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Making Sense of AIDS

Making Sense of AIDS: Culture, Sexuality, and Power in Melanesia

Leslie Butt
Richard Eves
Copyright Date: 2008
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  • Book Info
    Making Sense of AIDS
    Book Description:

    In Melanesia, rates of HIV infection are among the highest in the Pacific and increasing rapidly, with grave humanitarian, development, and political implications. There is a great need for social research on HIV/AIDS in the region to provide better insights into the sensitive issues surrounding HIV transmission. This collection, the first book on HIV and AIDS in the Pacific region, gathers together stunning and original accounts of the often surprising ways that people make sense of the AIDS epidemic in various parts of Melanesia. The volume addresses substantive issues concerning AIDS and contemporary sexualities, relations of power, and moralities—themes that provide a powerful backdrop for twenty-first century understandings of the tensions between sexuality, religion, and politics in many parts of the world.

    eISBN: 978-0-8248-6347-0
    Subjects: Public Health, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Foreword
    (pp. vii-xiv)
    Shirley Lindenbaum

    The human immunodeficiency virus (HIV) has taken us on a hunt along paths that lead in different directions. On the one hand, we document its transmission as it moves relentlessly around the world. On the other, we follow its manifestation in local eddies. This has resulted in strategies for research and intervention that differ vastly in scale. Broad-based strategies include a call for DNA fingerprinting to pinpoint and track the global movement of various HIV strains and clades (subgroups). DNA testing has shown already that the growing HIV epidemic in the former Soviet Union comes from a new strain spread...

  4. Acknowledgments
    (pp. xv-xv)
    Leslie Butt and Richard Eves
  5. Maps
    (pp. xvi-xviii)
  6. Introduction
    (pp. 1-23)
    Richard Eves and Leslie Butt

    So far unparalleled in magnitude, perseverance, and range, the AIDS pandemic may be the greatest public health disaster ever.¹ Though HIV has already made its way to all corners of the world, reaching places that in the past would have been spared because of their isolation, its full effects are yet to be felt. Until more successful means of dealing with it are found and implemented, it will continue to devastate future generations. Like the Black Death, AIDS has become inscribed in the popular imagination. As Herdt and Lindenbaum suggest, this disease has come to signify our era: we are...

  7. 1 When There’s No Accessing Basic Health Care: Local Politics and Responses to HIV/AIDS at Lake Kopiago, Papua New Guinea
    (pp. 24-40)
    Nicole Haley

    HIV/AIDS is a self-inflicted disease. It is spread by people who practise multiple sex and these are people who are prepared to step out of the normal human moral boundaries. In the end, they get the price they want. Why care about them? People with the HIV virus should not be given any equal rights or protections like law-abiding moral people.

    HIV virus carriers are carrying the deadly weapon (the virus) and are going to pass it on to others who also act like animals, committing adultery and fornication. They are like criminals who carry unlicensed guns to commit crime...

  8. 2 “It’s Mutual Attraction”: Transvestites and the Risk of HIV Transmission in Urban Papua
    (pp. 41-59)
    Jack Morin

    Althoughwaria—men who dress as women and identify themselves as women—are a readily recognizable part of life throughout Indonesia, their presence in Papua is recent, a reflection of the impact of Indonesian cultural values and social practices on the province over the past two decades.¹ Of the several hundredwariain the province, an increasing number are indigenous Papuan men who, like otherwaria, tend to be highly sexually active and often exchange sex for goods or money. From their different cultural backgrounds, these young Papuanwariahave established their transvestite identities in a context of momentous change,...

  9. 3 Fear and Loathing in Papua New Guinea: Sexual Health in a Nation under Siege
    (pp. 60-79)
    Lawrence J. Hammar

    According to the politician Jacob Sekewa, the solution to the problem of AIDS in Papua New Guinea is to “get really hard on those HIV virus carriers.” As he put it, “Just stigmatise them like criminals and crush them to death and let the moral people survive” (Sekewa 2004). Public discourse frequently has it that condoms are Satan’s tools, that one must beware of girls wearing six-pocket pants, and that prayer can cure the AIDS that church attendance didn’t prevent. Nightclubs, settlements, bush areas, and motel rooms are the breeding grounds of HIV, wherepamuk meri(promiscuous women) andtu...

  10. 4 Why Are Kanak Women More Vulnerable than Others to HIV? Ethnographic and Statistical Insights from New Caledonia
    (pp. 80-96)
    Christine Salomon and Christine Hamelin

    Sexual health and female HIV risk-taking behaviors are strongly affected by women’s social and cultural situation. The vulnerability of women to HIV in New Caledonia cannot be properly appreciated without understanding all of the conditions affecting their lives and the choices they can make. We argue that Kanak women, despite as yet modest rates of infection, are highly vulnerable to HIV, not only because of colonial history and current social inequalities, but also because of gender norms and relationships within the Kanak community. This includes a high rate of violence toward women whose ability to negotiate sex and protect themselves...

  11. 5 Buying Betel and Selling Sex: Contested Boundaries, Risk Milieus, and Discourses about HIV/AIDS in the Markham Valley, Papua New Guinea
    (pp. 97-115)
    Bettina Beer

    Despite the widespread epidemic in Papua New Guinea, the Wampar who live near the city of Lae in the Markham Valley (see map 2) do not yet know or talk about specific cases of HIV-infected people or cases of AIDS; nor do I know of any HIV-positive person in the area. Yet HIV/AIDS(sik nogut)is frequently discussed, for it is seen as a general threat to Wampar well-being and identity, as are certain other diseases, immigration, criminality, sorcery, immorality, and the (presumed) importation of drugs and weapons from Papua New Guinea’s highland provinces.¹ The HIV problem, then, is embedded...

  12. 6 Silence Speaks Volumes: Elite Responses to AIDS in Highlands Papua
    (pp. 116-132)
    Leslie Butt

    When faced with the threat of epidemics, argues Lindenbaum, social groups exhibit increased anxiety about social boundaries (1979, 1998, 2001). Solidifying the boundaries between insider and outsider, and so affirming the inclusiveness of each category of belonging, often allows marginalized groups to raise publicly questions that had been suppressed. As Lindenbaum and others have argued, the AIDS epidemic has the potential to galvanize oppressed groups, enabling them to question the distribution of power within states and governments (see Farmer 1992, 1994; Treichler 1999). In contemporary Papua (West Papua), Indonesia, it would seem that heightened panic and insecurity have loosened the...

  13. 7 The Trouble with Trousers: Gossip, Kastom, and Sexual Culture in Vanuatu
    (pp. 133-149)
    Maggie Cummings

    Epidemics, says Lindenbaum, are “lightning rods for eliciting the particular terrors that monitor the social forms and cultural values of different communities” (2001, 364; 1998). In Vanuatu (see map 1), the “particular terror” elicited by the AIDS epidemic is that social change, especially as informed by foreign influence and “modernization,” threatens to erode or destroykastom. Simply put,kastomis the word in Bislama (Vanuatu’s lingua franca) for cultural tradition, or indigenous knowledge and practices, particularly those that differentiate ni-Vanuatu (indigenous citizens) from foreigners and expatriates.¹Kastomis often invoked in nationalist imaginings of Vanuatu as the commonsense, static, and...

  14. 8 Love as Sacrifice: The Romantic Underground and Beliefs about HIV/AIDS in Manokwari, Papua
    (pp. 150-167)
    Sarah Hewat

    Romantic love, which in the West developed under the hegemony of capitalism and Christianity, has only recently begun to be incorporated into the cultures of many parts of the world (Hirsch and Wardlow 2006). This is not to say that the experience of amorous love is anything new, for the ability to feel an intensity of attraction and a sympathy of feeling for a love object seems to be common to all human beings (Jankowiak and Fischer 1992, 153). What is new is that in regions where familial, social, and practical reasons for marriage have traditionally been strongly preferred and...

  15. 9 Smoke from Fire: Desire and Secrecy in Auki, Solomon Islands
    (pp. 168-186)
    Holly Buchanan-Aruwafu and Rose Maebiru

    The first person was diagnosed with HIV in the Solomon Islands as early as 1994, but it was not until ten years later that increases began to be reported in the numbers of people living with HIV or who had died from AIDS. Today, while the numbers of persons officially reported to be infected appear extremely low, limited testing, inconsistent surveillance data, and variable blood screening make it difficult to assess the real epidemiological situation (Buchanan, Konare, and Namikori 1999; SIG MHMS and Oxfam 2004; SIG SINAC and NGOs 2005). These numbers also tell us very little about contextual or...

  16. 10 “You Have to Understand: Some of Us Are Glad AIDS Has Arrived”: Christianity and Condoms among the Huli, Papua New Guinea
    (pp. 187-205)
    Holly Wardlow

    I experienced a sinking feeling when a senior health official described to me the HIV/AIDS awareness program he had carried out in Tari, Southern Highlands Province, Papua New Guinea (see map 2). He had assembled some HIV-positive people and, armed with a loudspeaker, had “invited” them to testify in the marketplace about their previous sinful lives and how divine healing had saved them. It was worrisome that a prominent member of the local health care system was endorsing the view that HIV infection was the result of sin and announcing that a cure was possible through penitence and an appeal...

  17. 11 Moral Reform and Miraculous Cures: Christian Healing and AIDS in New Ireland, Papua New Guinea
    (pp. 206-223)
    Richard Eves

    As the AIDS epidemic gathers intensity and notice in Papua New Guinea, extravagant claims have materialized about wondrous cures for this disease that medical science has been unable to cure. Many of these claims are coming from so-called traditional healers—“so-called” because many of their remedies are recent inventions, which, rather than being based on a traditional corpus of knowledge, are products of today. These herbal remedies are being offered for sale at markets everywhere, with large banners proclaiming their ability to cure not onlysikAIDSbut many other illnesses and ailments as well.¹ A banner opposite the Goroka market...

  18. 12 SikAIDS: Deconstructing the Awareness Campaign in Rural West New Britain, Papua New Guinea
    (pp. 224-245)
    Naomi M. McPherson

    In 2003, when the Provincial AIDS Committee (PAC) opened in Kimbe, the capital of West New Britain Province, there were twenty recorded cases of HIV infection in the province. By 2005 the HIV/AIDS response coordinator knew of thirty-eight confirmed cases in the province but suspected that many more cases remained unreported because of lack of testing equipment and pre- and posttest counseling, poor confidentiality, and reluctance to be tested due to fear of stigma. Even these imperfect figures indicate an alarming increase of almost 100 percent in a two-year period. The PAC in Kimbe still has only two staff members,...

  19. 13 Fitting Condoms on Culture: Rethinking Approaches to HIV Prevention in the Trobriand Islands, Papua New Guinea
    (pp. 246-266)
    Katherine Lepani

    In tandem with the relentless spread of HIV infection throughout the world is a proliferation of ways of comprehending the virus and its effects, as different knowledge and belief systems converge and interact to produce meaning. Responding effectively to the challenges of the pandemic in diverse cultural settings involves an obligation to “continually reevaluate the concepts through which we understand HIV, looking closely at how the multiple levels of experience and the multiple forms of knowledge interrelate and change over time” (Patton 2002, xxiv). Yet communication about HIV and AIDS is based persistently on biomedical and epidemiological constructions of meaning,...

  20. Notes
    (pp. 267-278)
  21. Bibliography
    (pp. 279-306)
  22. Contributors
    (pp. 307-308)
  23. Index
    (pp. 309-320)
  24. Back Matter
    (pp. 321-326)