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Ancestors and Antiretrovirals: The Biopolitics of HIV/AIDS in Post-Apartheid South Africa
Author(s): Claire Laurier Decoteau (Author)
- Publisher: University of Chicago Press
- Publication Date: 30 Sept. 2013
- Edition: Illustrated
- Language: English
- Print length: 342 pages
- ISBN-10: 022606459X
- ISBN-13: 9780226064598
Book Description
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, “AIDS is South Africa’s new apartheid.”
In Ancestors and Antiretrovirals, Claire Laurier Decoteau backs up Tutu’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 Johannesburg’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.
Editorial Reviews
Review
"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."-- "USAID"
"Decoteau has undertaken ten years of research in South Africa, artfully presenting the lived experience of people infected with HIV/AIDS residing in the shantytowns around Johannesburg, and interweaving them with a sophisticated theoretical discussion of the complex issues surrounding the politics of HIV/AIDS in South Africa. She does a fantastic job in giving voice to the people caught in the middle of a multitude of crisscrossing processes and structures."-- "Choice"
"Decoteau's ambitious project spans a 14-year history (1996-2010) during which South Africa's national HIV/AIDS policies swung between extremes as the country's leaders attempted to find a way forward amid deepening inequalities and a worsening epidemic."
-- "Medical Anthropology Quarterly"
"
Ancestors and Antiretrovirals is timely and relevant. . . . Decoteau'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 formulates--and her examination of the discursive uses of 'tradition' and 'modernity' to resolve its abiding challenge--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."-- "International Journal of African Historical Studies""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."
--Isaac Ariail Reed "author of Interpretation and Social Knowledge: On the Use of Theory in the Human"
"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."--Adam Ashforth "author of Witchcraft, Violence, and Democracy in South Africa"
About the Author
Excerpt. © Reprinted by permission. All rights reserved.
Ancestors and Antiretrovirals
The Biopolitics of HIV/AIDS in Post-Apartheid South Africa
By CLAIRE LAURIER DECOTEAU
THE UNIVERSITY OF CHICAGO PRESS
Copyright © 2013 The University of Chicago
All rights reserved.
ISBN: 978-0-226-06459-8
Contents
Acknowledgments............................................................ixNote on Terminology........................................................xiiiAbbreviations..............................................................xvIntroduction Postcolonial Paradox..........................................11 The Struggle for Life in South Africa's Slums............................242 A State in Denial........................................................783 Biomedical Citizenship...................................................1134 The Politicization of Sexuality 163......................................5 Hybridity................................................................199Coda Life Strategies.......................................................236Notes......................................................................241Glossary...................................................................275References.................................................................277Index......................................................................315
CHAPTER 1
The Struggle for Life inSouth Africa's Slums
Pheello Limapo believes he has been HIV-infected since1994, when he suffered from a serious bout of tuberculosis."At the time, one of the doctors mentioned HIV, butno one was really familiar with the disease at this point,so this meant nothing to me and I quickly forgot aboutit." Pheello moved from the Free State to Johannesburgin 2001, where he initially worked in construction, buthis constant illnesses made this work difficult at first andeventually impossible. He first lived in central Johannesburgand then moved to a squatter camp about an hoursouthwest of Soweto, named Lawley, where he still livestoday. "My wife and I had a child before we knew we wereHIV positive, and the child died. We went to many doctorstrying to figure out what was wrong. Another childdied before we realized that we were both HIV infected,and that breast-feeding was part of the problem. We hada third child and did not breast-feed the child. This childis still fine, healthy and HIV negative." Pheello and Elizabethhad another HIV-negative child (thanks to nevirapineand formula milk) in 2008.
In 1999, Pheello became so ill he was hospitalized,and he was given an HIV antibody test. When he returnedfor the results, "the doctor called me into a specialroom where he actually disclosed my status to tell methat I'm positive.... Well, I chose not to believe it....When I went home, I decided to keep quiet, not to telleverybody, because I actually saw the kind of circumstances that willcome with it, especially if I disclose, because I will be discriminatedagainst at home and by everybody." At another point, he explained:"No one was talking about AIDS. I went to two funerals of comrades Iworked closely with in my community ... and no one mentioned thedisease." He paused and took a deep breath, "it was when my brotherdied that I realized that if I didn't take a chance and talk to people andask for help, I was going to die just like everyone else ... with no oneknowing."
And so Pheello started talking. He became a strong advocate forhimself and the other people in Lawley who were living with or affectedby HIV/AIDS. In addition to battling the silences and stigmasthat cloak the disease in his community, Pheello has learned there areother more insidious forms of political silence that need to be broken.He became involved in my research, he never ceased to remind me,because he strongly believed that the stories of people living with HIV/AIDS in squatter camps needed to be told as it was all too easy for thegovernment to forget they existed.
It's not that the government has got no capacity or no money to assist people livingwith HIV. There is a lot of money that is there for AIDS. A lot of this money isdonated from different countries all over the world.... And the government isonly the custodian of that money. But instead of the government using that moneywhere it is supposed to be used—like in the squatter camps, it uses this moneyto make millions of condoms and millions of fancy pamphlets. Spending a lot ofmoney on things that are secondary and not primary.... But it's the people in thesquatter camps who are vulnerable. The government does not even try to go to thesquatter camps to find out what is needed. It is the people with the nice lives whoare deciding on the money. People are struggling as we speak—in different squattercamps. But the government does not want to help us.
* * *
As Mike Davis (2006) points out, the rapid urbanization that has accompaniedthe global implementation of neoliberal economics has resultedin a "late capitalist triage of humanity" (199) in which millionsof people throughout the world have been converted into surplus populations,abandoned on the peripheries of hypercities, and marginalizedby their inability to participate in the accumulation or consumption ofcapital. The plight of informal settlement residents has recently becomea focus of international attention. Indeed, one of the United NationsMillennium Development Goals is to significantly improve the livesof slum dwellers globally by 2020 (UN 2010). Despite this increasingglobal awareness, there is still much to be learned about the intricatecausal relationships between neoliberalism, urbanization, and diseaseepidemiology, as postcolonial countries the world over fight to stemthe tide of increasing informality. In this chapter I provide historical,ethnographic, qualitative, and quantitative data on two squatter campsoutside of Johannesburg where I have been conducting research since2004: Sol Plaatjie and Lawley. I begin by providing detailed evidence ofthe endogenous relationship between poverty and HIV/AIDS, and thenexplain the material and ontological vulnerabilities associated with livingin slum conditions.
Informal Settlements
As in other developing countries, the historic "mushrooming" of informalsettlements in South Africa began in the 1980s due to rapiddeindustrialization and rising unemployment; however, in the SouthAfrican context, the relaxation and eventual eradication of influx controlsat the end of the decade accelerated an already escalating rate ofurbanization (Hunter 2007; Harrison 1992; Crankshaw 1993). There aredifferent kinds of housing informality in South Africa: "informal settlements"are squatter settlements of the urban poor that develop throughthe unauthorized occupation of land (Huchzermeyer and Karam2006, 3). Other informal dwellings include shacks built on serviced sitesor in the backyards of formal township houses (Huchzermeyer 1999).From 1996 to 2003 the number of informal dwellings rose by 688,000in South Africa, despite the existence of house-building projects fundedby the state (Hunter 2006, 160–61; Mail and Guardian 2006a). By 2009,14.4 percent of households (1.9 million) in South Africa were informaldwellings or shacks...
