Abstracts (2010)

Cole, Jill. “Sterilization of HIV-positive Women in Namibia.” The sterilization of HIV positive women without their knowledge or consent has been a growing issue among activists working towards human rights and gender equality in the Republic of Namibia since reports of the procedure first surfaced in 2007. Currently, litigation is underway whereby 3 of the allegedly sterilized women are taking Namibia’s Ministry of Health to court on the grounds that the sterilization procedures have violated their rights to non-discrimination, to found a family, and to dignity. Although the concept of dignity is the lynchpin of human rights discourse, it has gone undefined in most international proclamations. The Oxford English Dictionary defines it as the state or quality of being worthy of honor or respect. To actors on all sides of the issue of forced and coerced sterilization in Namibia, women living with HIV occupy a zone of exception in which the protection offered by claims to dignity and human rights is diffused in favor of the rights of unborn children, and thereby future generations, or society-at-large. In this paper, I analyze interviews with various actors involved in the issue and find that embedded in the discourse of advocacy NGOs and the sterilized women themselves, dignity is less an abstract quality and more a pragmatic concern that invokes culturally prescribed gender roles and vast structural inequalities. This paper contributes to research on the intensity of discrimination still surrounding HIV/ AIDS, and how such discrimination hampers efforts to address the rights of all people living with HIV/AIDS, especially women. Furthermore, I suggest that current human rights language glosses over important nuances in how such concepts as dignity are incorporated into strategies of local and national NGOs- in this case, in the Southern African country of Namibia.

Cunningham, Molly. “Basic Needs, Better Selves: Humanitarianism and Sovereignty in Botswana.” Drawing from five months of ethnographic fieldwork conducted in Gaborone in 2006-2007, this paper explores the role of American volunteers in the transnational NGO network undertaking humanitarian interventions and development initiatives in Botswana’s capitol city. In particular, I focus on the orphan as a locus of multiple mobilizations and site of fluctuating value through which these volunteers negotiate their own geopolitical identities and ethical selves in this terrain. I argue that the Botswana nation-state poses a challenge to the American imaginary of Africa as a place of absolute scarcity and need, forcing them to negotiate the personal stakes of their humanitarian impact around the broader landscape of HIV/AIDS work and the role of the Botswana state. This paper gestures toward three broad conclusions on the critical actors involved at the field site of a day-care for orphans and vulnerable children that hosts a constant stream of American volunteers and benefits largely from Botswana’s welfare state. First, I question how the sovereignty of the state is both asserted and undermined through welfare provision for orphans. Second, I explore how Americans use “the Global South” and “Africa” as sites to negotiate political and moral subjectivities of US citizenship, articulated in alternating and contradictory economies of commodity and gift exchange. Third, I argue the vulnerable body of the abandoned child becomes a critical site of political erasure when these contradictory roles and relations come to the fore.

Doherty, Jacob. “Esso Reports: Citizenship and Environmental Protection in Chad’s Doba Oilfields”

Fiorella, Katie. “Food by Prescription: The Medicalization of Food to Treat HIV/AIDS Patients in Mfangano Island, Kenya.” As Anti-Retroviral Therapy becomes more widely available in Africa, redressing food security and nutritional deficiencies remains critical for progress in HIV/AIDS treatment. HIV/AIDS patients face increased energy requirements (i) while food insecurity increases complications (ii, iii) undermines treatment adherence (iv), and reduces Anti-Retroviral Therapy efficacy. We examine food by prescription’s role in treating HIV/AIDS patients in Suba District, Kenya (Fig. 2), where HIV prevalence is estimated at over 30% (v, vi). Food by prescription is supplied by the World Food Programme/USAID and administered by the University of California, San Francisco (UCSF) and Kenya Medical Research Institute’s (KEMRI) Family Aids Care and Education Services (FACES) and the Kenyan Ministry of Health. Through a chart review of HIV/AIDS patients and comparisons of outcomes for patients who do and do not receive food by prescription we will evaluate the efficacy of this multi-partner program, determine socio-economic and epidemiological predictors of patients who are likely to require food by prescription, and recommend complementary nutrition programming.

Gupta, Clare. “Conserving Nature, Changing Diets: Local Perceptions of the Impact of Botswana’s Chobe National Park Policies on Communities and Health.” In the forty years since the establishment of Chobe National Park, the government of Botswana has introduced environmental conservation policies that restrict nearby residents’ access to land and resources. Limitations on what, where and how residents of five adjacent villages are allowed to hunt, fish and gather in the park has drastically increased reliance on store-bought food and transformed villagers’ livelihoods, diet and level of food security. In recent years, political ecologists have brought to light the deleterious effects that the creation of protected areas can have on local communities in terms of decreased access to natural resources and increased exposure to dangerous and destructive wild animals (Neumann 1992; West 2006). In addition, public health studies have empirically documented changes in diet and nutrition in various rural African locales (Gobotswang 1989). However, both types of studies tend to privilege a lead researcher’s theory- and data-driven analyses over local views and explanations of processes of change. In contrast, this paper examines the way in which residents’ themselves understand the causal linkages between regulations associated with the national park, subsequent changes in food sources, and bodily health. The aim of this paper is to take seriously local perceptions of the relationship between government policy, diet and the health status of community members. In Botswana, where the AIDS epidemic has caused broad concern regarding people’s health-related beliefs and practices, it is particularly important to examine relationships between health, governance and socio-economic change through the eyes of local communities and to understand how and why these perceptions have developed.

Hokkanen, Marku. “Medicine(s) and Migration: Mobile Medical Experts, Middles and Migrants in Colonial Malawi.” Malawi is a landlocked country with few modern medical services. Its medical history is marked by mobile medical figures, both African and European, who have passed through the country, migrated to pursue education or a career elsewhere (sometimes returning), or settled for a period and moved on. This paper (based on archival research and recent interviews) deals with mobility, migrancy and expertise among Africans and Europeans in colonial Malawi. It argues that in the construction of expertise and authority, mobility was a prominent factor in the careers of medical men and women, which needs to be taken into account in the histories of medicine, healing and health. The paper analyses the meanings, possibilities and limitations that mobility and migrancy (both within Southern Africa and in the wider networks of the British Empire) had for Malawian ‘middles’ trained in Western medicine, indigenous healers and colonial medical personnel. Furthermore, it explores the movement of medicines and therapies, both African and Western. The study of the movements of various medical men and women, and their medicines and practices, can enable a better understanding of the continuities and ruptures in the history of medicine and health in colonial and modern Africa. As an exploratory case-study, this paper will hopefully contribute to research which transcends geographical boundaries in history and anthropology.

Jarvis, Lauren. “The Nazareth Baptist Church and Contests over Healing in Segregationist South Africa.”

Masakure, Clement. “Requesting Permission to Arrest All Cholera Sufferers, Your Excellency: Cholera and Politics in Zimbabwe.” Tony Namate’s cartoon stands out as one of the best social commentaries on the politicization of cholera in Zimbabwe. An overweight anti-riot commander petitions Zimbabwe’s president Robert Mugabe the authorization to arrest all cholera sufferers. As much as I am inspired by this cartoon, my work is also a personal project. In this work, I trace the cholera outbreak and examine its implications on politics in Zimbabwe. At the same time, I historicize public health system in Zimbabwe. I suggest that scholars and health activists need to look at the outbreak and spread of cholera in 2008 as an important event that clearly exposed the decline in hospital system and the collapse of public health sector. Whilst the opposition party, Movement for Democratic Change (MDC) argued that the outbreaks were a clear indicator of mismanagement and failure in governance, ZANU PF spin doctors used conspiracy theories in their efforts to come to terms with the cholera epidemic. ZANU PF mandarins argued that the outbreak was biological warfare by Britain against the people of Zimbabwe and part of regime change agenda. Besides exposing the collapse of the health sector, I argue that the outbreak and spread of cholera gave competing political parties a new arena to mobilize political support. The struggle over the cholera epidemic became a struggle within the struggle, as it became imbedded in the political contests between ZANU PF and the MDC. Mugabe’s decision to declare the cholera epidemic ‘a disaster,’ allowing intervention at a massive scale I argue was more of a political move than a medical one.

McPherson, Dacia. “Allocating the Burden of Proof: The Implications of Male Circumcision Planning in Rwanda for Decision Making in International Health.” This research analyzes international policies for male circumcision and their application in Rwanda—a small country in east Africa with a burgeoning population and economy, with strong public health governance and also where the author spent time embedded within the Rwandan Centers of Infectious Disease Control modeling the implementation of male circumcision. The question of male circumcision in Rwanda provides a case study for current trends in decision-making under uncertainty within the realm of international health and development. Robust metrics and evaluation systems for efficient and effective information sharing, while a top priority on the agendas of many practitioners, governments and multilateral institutions, are still in a nascent stage in much of the developing world. Capturing evidence to make decisions then, is a subjective procedure and rightly so. Subjecting all information, agreeable or otherwise, to thoughtful scrutiny is an inexhaustible task. This research analyzes how different stakeholders promote distinct perspectives to safeguard their objectives. In an attempt to understand these differences, the role of empiric modeling exercises and precautionary approaches in the political bargaining game will be debated. Whether disparate perspectives harm or help the policy implementation process will also be addressed. Here, historical hurdles to policy implementation will be discussed as they have relevance to policy making in international health today. Finally, by integrating lessons learned recommendations will be offered. In the call to prevention and long term planning for global health, forecasting potential outcomes into the future will be necessary. Streamlining this process should be a goal of priority.

Sasser, Jade. “Constructing the Sexual Steward: African Women, Fertility, and Environmental Responsibility.” Recent efforts by environmental, population, and reproductive health organizations have increasingly sought to link African female fertility with an array of forms of global environmental degradation, ranging from declines in biological diversity, food and water scarcity, and the increasing threat of climate change. This paper explores the practices through which a range of multisectoral international development actors construct notions of African gender norms, sexuality and reproduction via educational workshops, advocacy trainings, and community mobilization strategies. These mobilizations are designed to draw explicit discursive links between fertile African bodies, environmental degradation, and advocacy efforts in the U.S. I argue that these practices constitute efforts to construct a particular type of African female subject: the sexual steward. The concept of sexual stewardship provides development actors with a means of locating environmental decline and rapid population growth in moralistic and public health frameworks, while facilitating the reframing of historical population control efforts through the contemporary lens of women’s development.

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