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Lecture 3

GGRB28 READINGS week 3.doc

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Michelle Majeed

GGRB28 CLASS 3 readings Farmer Chapter 4 (The Exotic and the Mundane) • The author admits that training in anthropology had induced him to “misdiagnose” structural violence as cultural difference. • Critical epidemiology had the power to reveal a great deal about a novel infectious disease • Since AIDS in the Caribbean is a translational pandemic shaped by conditions and structures long in place, a Critical epidemiology, will necessarily be historically deep and geographical broad. • In a meeting with the Haitian community about AIDS, one U.S physician was taken to task for his “racist speculations” about Haitians being a risk group for AIDS. • Others also published outlandish speculations purporting to explain AIDS in Haiti, including the assertion that “magic ritual provides a means for transfer of blood and secretions from person to person. • Women have been known to introduce menstrual blood into the food and drink of their partners to prevent them from “straying” • The author, working through the problem in Haiti, found a perspective: which might be termed “biosocial” rather than the fuzzy, now new age term “holistic”. • He found “accusation” to be a dominant theme through his experience among Port-au-Prince professionals. • Social responses to the new disease, like the disease itself, linked Haiti’s rural Central Plateau to the city of Port-au-Prince, and beyond that, to the United States. This was a matter of moral geography: a “geography of blame” • Solange Eliodor was a woman who fled to U.S as a refugee…and died. Her story—flight by boat from Haiti, U.S Immigration detention, newspaper headlines, mistaken diagnosis of tuberculosis and official violence – is of a piece with a single narrative. • The Haitian cases and the subsequent risk-grouping spurred a wide range of theories purporting to explain the epidemiology and origins of AIDS. • The theory that Haitian virus was brought back to the homosexual population in the United States was echoed by many scientists and physicians investigating AIDS. • Other pundits in Europe and North America linked AIDS in Haiti to “voodoo practices” • Haiti has long been depicted as a strange and hopelessly diseased polity remarkable chiefly for its extreme isolation from the rest of the civilized world. A journalist back in 1989 writing for Vanity Fair claimed that Haiti is to this hemisphere what black holes are to outer space. • At the time of this writing, Haiti, Guyana, and Brazil stand alone among this hemisphere’s nations as countries afflicted with generalized epidemics (in which infection is prevalent from mother to child). • Most chroniclers of the AIDS pandemic agree that awareness of the new syndrome began to emerge in California in 1981. • Kaposi’s sarcoma was linked to this. • Pape and co-workers in their study found that 74 percent of all men with opportunistic infections lived in greater Port-au-Prince. • Some conclusions made from the research were: • 1) Haitians with AIDS were largely men • 2) The epicenter of the Haitian epidemic was in the city of Carrefour, home to Haiti’s largest red-light district. • 3) A large percentage of the early cases were linked to homosexual contact, some of it with North Americans and involving the exchange of money. • 4) The association with a history of blood transfusions seemed to be greater in Haiti than in the United States. • 5) Although the opportunistic infections often differed from those seen in North Americans with AIDS, the Haitian epidemic was very similar to that in the U.S. • We can discern an “American phase” of the Haitian epidemic, in which risk factors for HIV seemed to reflect those identified in the US • To understand the West Atlantic AIDS Pandemic, a historical understanding of the worldwide spread of HIV is crucial. • This critique by the author as practical effects on preventive strategies and treatment efforts. • Lurid scenarios were promoted in the popular press, which offered images of voodoo, animal(and even human) sacrifice, and boatloads of disease-ridden refeugees. • Such articles had a considerable impact on Haiti, which once was counted tourism as an important source of foreign currency. Haiti was made an international pariah by AIDS • In research conducted among Haitian Americans with AIDS, none of the “accepted risk factors” were identified- that is. Homosexuality, bisexuality, injection, drug use, blood transfusion or hemophilia. • The most striking revelation, in lights of reports about Haitians with AIDS in the U.S, was that fully half of the male patients interviewed in Port-au-Prince had a history of sexual relations with men. None of them, however, was exclusively homosexual. So being bisexual, it provides greater opportunity for heterosexual transmission of AIDS. • Haiti plays an interesting role in what has been termed “West Atlantic system”, an economic network encompassing much of the Caribbean basin. • AIDS in Haiti is all about proximity, not distance. It is tied to the U.S, not Africa. It is about inequality, both local and transnational. The ‘problem’ of Asian women’s sexuality: public discourses in Aotearoa/ New Zealand (Rachel Simon-Kuma)* • The reproductive and sexual health of Asian communities has emerged as a “problem” in public health circles in New Zealand. • High rates of abortion are evident among women of Asian descent.(fastest growing ethnic group in NZ) • Cultural values lie at the heart of this problem. • Informed by feminist perspectives that emphasize sexuality as a ‘meaning system’, the key question that this paper explores is: How are social and cultural values implicated in the definition of the Asian sexual health ‘problem’ in New Zealand? • In 2002, there was sudden high public interest in the sexual health of Asian people in NZ, especially headlines about multi-abortion, high abortion rates etc. • The remarkable aspect of perceptions of these Asian women– and what has caught the public imagination – is that they integrate sexual practices of Asian female students with their identity as migrants in New Zealand, so that abortion becomes a negative consequence of young people confronted with contrasting values of opposing cultures. • Media and research suggested that Asian women were inhibited by their cultural norms around femininity. • Media and medical research constructed an image of young Asian female overseas students in New Zealand who, on the one hand, were lonely, isolated and impressionable in an alien cultural setting without family networks but who, simultaneously, were also developing promiscuous habits and permissive lifestyles, despite their ignorance of sexuality. • Medical professionals noted that young women did not discuss contraception or pregnancy either
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