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GGRB28H3 (32)
Chapter 4

Chapter 4

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Mark Hunter

Chapter 4The Exotic and the Mundane Human Immunodeficiency Virus in the Caribbeany Training in anthropology had induced me to misdiagnose structural violence as cultural difference y 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 Worshippers of Erzulie a benign deity engage in rituals during which the houngan or priest may engage in intercourse with other male worshippers The thought flickered across my mind that perhaps Haitians who believed that AIDS was a US biological experiment gone wrong were not as paranoid as they might seemor at least that their vivid imaginations were of a kind with accredited US experts y I knew that science cultures and transnational inequalities were coming together in a volatile mix y Working through the problems of AIDS in Haiti combing a diverse body of literature epidemiology clinical medicine virology social theory the popular press even fiction for clues and confirmations I found a perspectivewhich might be termed biosocial rather than the fuzzy now New Age term holisticthat has since served me well y Ethnographic fieldwork helped to illuminate both the curiously accusatory tenor of public discussions of AIDS and the forces that structured them y Indeed the disease has spread beyond and neatly defined risk groups and now constitutes what epidemiologists call a generalized epidemic in which infection is prevalent from mother to child y In Chapter 2 I argued that models of disease emergence need to be dynamic systematic and critical uncovering connections and patterns that are often obscured by conventional epidemiology and examining the role of social forces and inequalities Such an approach is essential to understanding the emergences of AIDS in Haiti and throughout the Caribbean A Chronology of the AIDSHIV Epidemic in Haiti y Most chroniclers of the AIDS pandemic agree that awareness of the new syndrome began to emerge in California in 1981y Alerted to the possibility of an epidemic US public health specialists reviewed available documentation and observed that unexpected clusterings of Kaposis sarcoma and opportunistic infections had first been noted early in 1977 Shortly thereafter Haitian physicians began to see similarly puzzling cases of immunosuppression y Researchers noted early on that a smaller proportion of Haitian AIDS patients had Pneumocystis carinii pneumonia the most common opportunistic infection in North Americans with AIDS M aviumintracellulare an infection common in North American AIDS patients was rare in Haiti although the Haitian patients did have mycobacterial infections these infections were almost exclusively tuberculosis
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