Sins of Omission: Public Health and HIV/AIDS in Africa

By Rodlach, Alexander | African Studies Quarterly, Winter 2013 | Go to article overview

Sins of Omission: Public Health and HIV/AIDS in Africa


Rodlach, Alexander, African Studies Quarterly


Gregory Barz and Judah M. Cohen (eds.). 2011. The Culture of AIDS in Africa: Hope and Healing Through Music and the Arts. Oxford: Oxford University Press. 500 pp.

Patricia C. Henderson. 2011. AIDS, Intimacy and Care in Rural KwaZulu-Natal: A Kinship of Bones. Amsterdam: Amsterdam University Press. 254 pp.

Aginam Obijiofor and Martin R. Rupiya (eds.). 2012. HIV/AIDS and the Security Sector in Africa. Tokyo: United Nations University Press. 281 pp.

Ross Parsons. 2012. Growing Up With HIV in Zimbabwe--One Day This Will All Be Over. Woodbridge: James Currey. 197 pp.

Jenny Trinitapoli and Alexander Weinreb. 2012. Religion and AIDS in Africa. Oxford: Oxford University Press. 279 pp.

Introduction

Several books and edited volumes exploring issues related to HIV and AIDS in Africa have recently been published. Some are distinguished from mainstream publications, which focus on themes considered important by the establishment, by their exploration of aspects of HIV and AIDS in Africa that have been insufficiently recognized and addressed by health care providers, policy makers, and funding organizations. The five publications--authored by anthropologists, artists, civil servants, political scientists, psychotherapists, and sociologists --reviewed in this article are particularly valuable in this regard. They discuss oversights that can be conceptualized as "sins of omission," referring to the failure to do something that can and ought to be done regarding the prevention of new infections, treatment, and care for those living with HIV and AIDS and their households. The choice of "sin" is deliberate to underscore the moral implications of our research, which can ameliorate or exacerbate human suffering. The books are reviewed in no particular order; however, the first book's ethnographic approach allows the reader a multifaceted glimpse at the experience of living with HIV and AIDS, introducing the topic.

Sin of Omission I--Lack of Support for Care Provided Outside Formal Health Care

During three years of ethnographic fieldwork, Henderson, an anthropologist, studied individuals' experiences of living in the context of HIV and AIDS in KwaZulu-Natal, South Africa. In particular, she records the suffering from HIV and AIDS prior to the rollout of antiretroviral treatment (ART), and highlights patterns of care outside of the formal health care sector within a context of limited resources. The subtitle of the book--A Kinship of Bones --refers to meanings "related to sociality, relationships and intimacy" (p. 18), which are essential for understanding caregiving. The body's flesh disappearing during the progression of AIDS mirrors a disintegration of social relations and intimacy. Yet, because of their durability, bones are also linked to strength and endurance. The author discusses aspects of care that are both provided and withheld in relations of intimacy, kinship, and neighborliness, particularly through reference to touch, support, and the use of language in the context of illness.

The author first explores the effects of HIV and AIDS on the human body and links them to local notions of the "proper" physical and social body. Henderson then raises the question of research and care ethics in relation to people who are dying or in mourning, emphasizing the unfolding nature of research and care. Subsequently, she argues that children who have lost one or both parents are not passive and powerless; they exercise a considerable amount of agency in soliciting support from others. What follows is a discussion about care from the point of view of healers, who understand HIV/AIDS through reference to past social dissonance and histories of discrimination, and integrate indigenous and biomedical frameworks when explaining and treating illnesses. The author then explores the tensions between the desire for procreation, intimacy, and care among couples living with HIV and AIDS. …

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