lunes, marzo 16, 2009

Farmer and Kim (1991), Castro and Farmer (2005), and Farmer (1999)

Farmer, Paul and Jim Jim Yong Kim. “Anthropology, Accountability and the Prevention of AIDS” The Journal of Sex Research 28.2 (May 1991): 203-221

Castro A and Paul Farmer. “Understanding and addressing AIDS- related stigma: from anthropological theory to clinical practice in Haiti” American Journal of Public Health. 95.1 (Jan 2005):53-59

Farmer, Paul. “Invisible Women: Class, Gender and HIV” Infections and Inequalities: The Modern Plagues Berkeley: University of California Press.

On this week we have texts that focus on HIV/AIDS and the different ways it has been associated with for instance Haitian people or with poor women across the world. In the fist article Farmer and Kim highlight the racist and inaccurate beliefs in the physical and social sciences in relation to the origin of AIDS. For many years the common assumption was that AIDS was introduced as a foreign invasion from Haiti to USA. The specific targets of those assumptions were Haitians because many researchers and specialists had put their explanatory believes in the conviction that Haiti was the cradle of AIDS. This belief, based on racist and discriminatory notions, was then proven wrong, but the consequences of it have lasting effects in how Haitian were (mis)treated in the USA. For a real prevention of AIDS, Farmer and Kim suggest, issues of AIDS-related discrimination to Haitian had to be unpacked and re-considered. The authors conclude with five projects regarding the “ethical considerations in anthropological research on AIDS”: 1) to explain why AIDS is becoming an illness of the disadvantaged? Why so many Afro American and Hispanics have AIDS in comparison with other groups? (Which political economy is producing this type of outcome?); 2) a cultural critique to different socio-cultural responses to AIDS and how stigma works differently in Haiti or in USA; 3) to witness and to honor the memory of individuals who have died from AIDS, and of communities affected by AIDS and stigma; 4) to counteract false and irresponsible misinformation, fear and racism; and 5) to show the effects of this misinformation and work as “cultural-activist” not only “to the AIDS pandemic, but to the epidemic of discrimination that has risen in the wake of HIV” (1991: 219).

In the second article, Castro and Farmer move one step further and focus on AIDS-related stigma in Haiti from both anthropological and clinical approaches. For the authors stigma and discrimination is a form of Human Rights violation. Stigma/discrimination is built under relations of power, dominance, hegemony and oppression but is too constantly resisted. AIDS-related stigma is produced by the social formation of structural violence, forces that include racism, sexism, political violence, poverty and other inequalities rooted in historical-economical processes that shape the circulation and results of HIV/AIDS. The authors show that although still within processes of medicalization, there are two completely different forms of approaching people’s experiences with AIDS: one that I would call as “re-medicalization but with good faith”, what Castro and Farmer propose in this article (to support people with AIDS with HAART (highly active antiretroviral therapy), which creates a “virtuous social circle”; and, what I would call as “re-medicalization with bad faith” (expropriation of people’s own experience), which creates a “vicious social circle.” For Castro and Farmer, “only a biosocial framework drawing on both qualitative and quantitative methods can hope to assess the epidemiological, social and economic impact of both the epidemic and responses to it” (2005: 57).

In the third article, Paul Farmer highlights the fatal connection between women, poverty and AIDS around the world, a connection that is almost invisible in the public and scientific perception. First, AIDS was considered a disease of men, but since the beginning they were affected and especially poor, young, women. From the 1990s in the so-called developing world more women than men became infected with HIV. For Farmer, the experience these women have “is a result of structural violence: neither culture nor pure individual will is at fault; rather, historically given (and often economically driven) processes and forces conspire to constrain individual agency” (79). Poor women were, and are, silenced from public discussion; indeed, they have been unheard. These women suffer the “triple curse” of objectification, institutionalized powerlessness, and blame for their condition. For Farmer, some of the myths and mystification that are part of poor women with AIDS’s lives is what he calls as the “exaggeration of personal agency”, and he adds, “There is nothing wrong with underlining personal agency, but there is something unfair about using personal responsibility as a basis for assigning blame while simultaneously denying those who are being blamed the opportunity to exert agency in their lives” (84). Efforts to change this situation should be oriented to empower poor women, and this means to find ways to let them gain control over their own lives.

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