Description
Book SynopsisThe Bushbuckridge region of South Africa has one of the highest rates of HIV infection in the world. Having first arrived in the area in the early 1990s, the disease spread rapidly, and by 2008 life expectancies had fallen by 12 years for men and 14 years for women. Since 2005, public health facilities have increasingly offered free HAART (highly active antiretroviral therapy) treatment, offering a degree of hope, but uptake and adherence to the therapy has been sporadic and uneven. Drawing on his extensive ethnographic research, carried out in Bushbuckridge over the course of 25 years, Isak Niehaus reveals how the AIDS pandemic has been experienced at the village-level. Most significantly, he shows how local cultural practices and values have shaped responses to the epidemic. For example, while local attitudes towards death and misfortune have contributed to the stigma around AIDS, kinship structures have also facilitated the adoption and care of AIDS orphans. Such practices challenge us to rethink the role played by culture in understanding and treating sickness, with Niehaus showing how an appreciation of local beliefs and customs is essential to any effective strategy of AIDS treatment. Overturning many of our assumptions on disease prevention, the book is essential reading for practitioners as well as researchers in global health, anthropology, sociology, epidemiology and scholars interested in public health and administration in sub-Saharan Africa.
Trade ReviewA brilliant and vivid ethnographic account of how people’s understanding and treatment of HIV/AIDS intersects with existing social and symbolic meanings around disease, death, witchcraft, healing strategies and everyday social interactions in Bushbuckridge, South Africa. * Alcinda Honwana, author of Youth and Revolution in Tunisia *
Building on some three decades of experience, Niehaus offers a superb analysis of the South African HIV/AIDS epidemic. A necessary reminder of how anthropological questions of kinship and misfortune remain highly significant to any understanding of HIV/AIDS. * Julie Livingston, New York University *
Niehaus returns us to the fundamentals of anthropology, offering a subtle but sharp critique of the Foucauldian turn in health. This is a superb ethnography – among its contributions the best critique of mainstream views on AIDS orphans I have seen. * Mark Hunter, author of Love in the Time of AIDS *
Niehaus captures the diversity of experiences of those living with HIV/AIDS in Bushbuckridge, South Africa. He reminds us that effective community engagement and efforts to counter stigma must be at the forefront of the global response to HIV/AIDS. * Peter Piot, London School of Hygiene & Tropical Medicine *
Table of ContentsMaps Preface and Acknowledgments 1. Introduction 2. Death 3. Blame 4. Words 5. Knowledge 6. Dreams 7. Care 8. Conclusions
