The Bio-Politics of HIV/AIDS in Post-Apartheid South Africa.

Abstract

This project explores root causes of health inequality by combining an ethnography situated within communities ravaged by the dual pandemics of poverty and HIV/AIDS with a political-economic analysis of the post-apartheid health system. Drawing on 27 months of ethnographic research in one former township and two informal settlements outside of Johannesburg, it contends that affected populations’ healing ideologies and itineraries, as well as their gender and sexual practices are at odds with the dominant discourses and policies imposed by international health agencies and the post-apartheid state. In examining this disjuncture, the project argues that HIV-infected, Black South Africans have incorporated a culturally hybrid identity – one which amalgamates different African cultures as well as cultural ideologies derived from international, national and local influences. This cultural hybridity is made possible by the historical conjuncture of events which marked the transition from apartheid to post-apartheid, and it allows the subjects of post-apartheid to circumnavigate the material strictures erected by both neoliberal economic restructuring and the pandemic itself. Biomedical and ‘traditional’ healing promote contradictory ontologies of the body and are situated within competing institutional frameworks. Further, public sphere discourses insist upon their radical incommensurability. The primary question motivating this research is, then, why do South Africans deeply affected by HIV/AIDS utilize traditional and biomedical forms of healing simultaneously, and without experiencing any sense of incongruity? The project deploys Pierre Bourdieu’s concepts of field, capital and habitus to explore the puzzling way in which people combine multiple healing strategies despite the bifurcated nature of the field of health. In so doing, it analyzes the effect of neoliberal economic restructuring on peoples’ health-seeking behavior, the symbolic struggle over the signification of HIV/AIDS ravaging South Africa’s public sphere, the relationship between local and global conceptualizations of disease, and the way in which subjects’ hybrid health itineraries are stimulating shifts in the configuration of gender, sexuality, and race politics. The hybrid nature of Black South Africans’ identities has been ignored by both policy initiatives and academic research, which either attempt to impose biomedical hegemony from above, or at least assume a certain static or culturally homogenous disposition.