When Bodies Remember Experiences & Politics of AIDS in South Africa

"Didier Fassin makes a compelling case against behaviorist approaches that dominate AIDS research. Using a vivid mosaic of public controversies and ethnographic vignettes, Fassin works through the controversial denials of South African President Thabo Mbeki and the precautionary policies of his Health Ministers within histories of apartheid, epidemics which justified segregation, and secret biological warfare plans of Project Coast, as well as wider battles over the ethical protocols of AIDS testing and widening inequalities. Fassin writes with compassion and deep moral inquietude."and#151;Michael M.J. Fischer, author of Emergent Forms of Life and the Anthropological Voice

"When Bodies Remember is an extraordinary exercise in counterpoint between the disquieting politics and the subjective experience of AIDS in South Africa. Didier Fassin deftly leads his readers into the 'heart of darkness' that we may comprehend this monstrous tragedy, literally unspeakable for so many, as one that touches our shared humanity. He insists that recognition of inequality rather than difference, and of embodied history rather than culture, are the keys to overcoming indifference, inciting in its place moral outrage and action. This brilliant, sensitive ethnography should be read by everyone who cares about the kind of world we live in."and#151;Margaret Lock, author of Twice Dead: Organ Transplants and the Reinvention of Death

"A gracefully written and politically astute account of one of the world's greatest AIDS tragedies, the arrival of a full-blown AIDS epidemic in South Africa on the cusp of political victory and jubilation over the end of apartheid. The cultural and political logic of President Mbeki's refusal to accept the international public health model of the virus and his pursuit of an alternative explanation of the epidemic is given a fair and just hearing by France's leading critical medical anthropologist."and#151;Nancy Scheper-Hughes, author of Death without Weeping

"This is a remarkable book. As Fassin dissects the deadly powers of today, he also unrelentingly looks for human alternatives to turn the AIDS tragedy around. Multi-layered and deeply moving, When Bodies Remember sets new standards for anthropological theory in the 21st century. The book's interpretive care and hope will stay with you in times to come."and#151;Joand#227;o Biehl, author of Vita: Life in a Zone of Social Abandonment

and#8220;This ethnography is comprehensive and nuanced in its approach. . . . Fassinand#8217;s ethnography is ambitious and provocative. It is recommended to anyone interested in exploring how the past critically shapes the present characterization of AIDS in South Africa.and#8221;

"Decoteau has undertaken ten years of research in South Africa, artfullyand#160;presenting the lived experience of people infected with HIV/AIDS residing in the shantytowns around Johannesburg,and#160;and interweaving them with a sophisticated theoretical discussion of the complex issues surrounding the politics ofand#160;HIV/AIDS in South Africa. She does a fantastic job in giving voice to the people caught in the middle of a multitudeand#160;of crisscrossing processes and structures."

"Ancestors and Antiretroviralsand#160;is a highly accessible book for non-sociologists that does not sacrifice analytic rigor in its presentation of peoplesand#8217; lives. Decoteau is a gifted photographer and purveyor of mixed methods who skillfully interlaces seemingly divergent theorists to articulate complex distinctions and integrations of tradition and modernity."

"Decoteau eloquently traces the politics of HIV and AIDS from 1994 through 2010 in Post-Apartheid South Africa. She describes important shifts in health policy and nestles them in real-life stories of people living with HIV and dying from AIDS. Her ethnographic data, collected over ten years, highlights several key issues including the changing relationship between indigenous and biomedical health care and the complex and often contradictory way that the South African government failed to balance a neoliberal existence (i.e., political movement beginning in the 1960s that blends traditional liberal concerns for social justice with an emphasis on economic growth.) with the health needs of its citizens."

"Decoteauand#8217;s ambitious project spans a 14-year history (1996and#8211;2010) during which South Africaand#8217;s national HIV/AIDS policies swung between extremes as the countryand#8217;s leaders attempted to find a way forward amid deepening inequalities and a worsening epidemic."

and#160;andldquo;In Ancestors and Antiretrovirals, Claire Decoteau draws together ethnographic fieldwork, unique insights into the experience of people suffering from AIDS at a time of callous governmental indifference, and a thorough reading of cultural politics to situate South Africa in the global economic system. Decoteau not only illuminates the many still baffling aspects of the epidemic and post-apartheid politics in South Africa, but challenges some of the core assumptions of Western social science. This is essential reading.andrdquo;

and#8220;Claire Laurier Decoteau is at the forefront of the new global sociology. Her articulation of analysis with ethnographic detail is expert, yet reads effortlessly; her ability to view the political complexities of South Africa from a new theoretical angle is admirable; and her depth of understanding about what is at stake in the fight over AIDS is relevant to anyone who wonders how power works all over the globe. Ancestors and Antiretrovirals will be an iconic text for a new generation of global work, and marks the emergence of a bold new theoretical voice in sociology.and#8221;

and#8220;Ancestors and Antiretrovirals is timely and relevant. . . . Decoteauand#8217;s inventive use of theory, able analysis of discourse, and commitment to tether her work to lived experience provide a model for young scholars. The postcolonial paradox Decoteau formulatesand#8212;and her examination of the discursive uses of and#8216;traditionand#8217; and and#8216;modernityand#8217; to resolve its abiding challengeand#8212;not only illuminates AIDS conflicts of the recent past, but also offers useful tools for analyzing current and future political contestation in postapartheid South Africa.and#8221;

In this book, France's leading medical anthropologist takes on one of the most tragic stories of the global AIDS crisisand#151;the failure of the ANC government to stem the tide of the AIDS epidemic in South Africa. Didier Fassin traces the deep roots of the AIDS crisis to apartheid and, before that, to the colonial period.

One person in ten is infected with HIV in South Africa, and President Thabo Mbeki has initiated a global controversy by funding questionable medical research, casting doubt on the benefits of preventing mother-to-child transmission, and embracing dissidents who challenge the viral theory of AIDS. Fassin contextualizes Mbeki's position by sensitively exploring issues of race and genocide that surround this controversy. Basing his discussion on vivid ethnographical data collected in the townships of Johannesburg, he passionately demonstrates that the unprecedented epidemiological crisis in South Africa is a demographic catastrophe as well as a human tragedy, one that cannot be understood without reference to the social history of the country, in particular to institutionalized racial inequality as the fundamental principle of government during the past century.

In the years since the end of apartheid, South Africans have enjoyed a progressive constitution, considerable access to social services for the poor and sick, and a booming economy that has made their nation into one of the wealthiest on the continent. At the same time, South Africa experiences extremely unequal income distribution, and its citizens suffer the highest prevalence of HIV in the world. As Archbishop Desmond Tutu has noted, andldquo;AIDS is South Africaandrsquo;s new apartheid.andrdquo;

In Ancestors and Antiretrovirals, Claire Laurier Decoteau backs up Tutuandrsquo;s assertion with powerful arguments about how this came to pass. Decoteau traces the historical shifts in health policy after apartheid and describes their effects, detailing, in particular, the changing relationship between biomedical and indigenous health care, both at the national and the local level. Decoteau tells this story from the perspective of those living with and dying from AIDS in Johannesburgandrsquo;s squatter camps. At the same time, she exposes the complex and often contradictory ways that the South African government has failed to balance the demands of neoliberal capital with the considerable health needs of its population.

Didier Fassin is Professor of Sociology at the University of Paris North and Director of Studies in Anthropology at the École des hautes études en sciences sociales in Paris. He is the Director of CRESP (Centre de recherche sur les enjeux contemporains en santé publique) and, until 2003, was vice president of Doctors without Borders. Among his books are Pouvoir et maladie en Afrique, L'espace politique de la santé, Les enjeux politiques de la santé, Des maux indicibles and Faire de la santé publique.

Introduction: Political Anesthesia and Anthropological Concern

1. As If Nothing Ever Happened

The Controversy

A Life

Proposition 1: The Structures of Time

2. An Epidemic of Disputes

Beginnings

Heresy

Proposition 2: The Configuration of the Polemics

3. Anatomy of the Controversies

Ordeals

Arenas

Proposition 3: The Figures of Denial

4. The Imprint of the Past

Long Memory

Bared History

Proposition 4: The History of the Vanquished

5. The Embodiment of the World

Behind the Landscapes

Within the Narratives

Proposition 5: The Forms of Experience

6. Living with Death

Dying

Born Again

Proposition 6: Politics of Life

Conclusion: This World We Live In

Notes

Brief Chronology of South African History

Maps

Bibliography

Index