The Republic of Therapy: Triage and Sovereignty in West Africa’s Time of AIDS (Body, Commodity, Text)

The Republic of Therapy tells the story of the global response to the HIV epidemic from the perspective of community organizers, activists, and people living with HIV in West Africa. Drawing on his experiences as a physician and anthropologist in Burkina Faso and Côte d’Ivoire, Vinh-Kim Nguyen focuses on the period between 1994, when effective antiretroviral treatments for HIV were discovered, and 2000, when the global health community acknowledged a right to treatment, making the drugs more available. During the intervening years, when antiretrovirals were scarce in Africa, triage decisions were made determining who would receive lifesaving treatment. Nguyen explains how those decisions altered social relations in West Africa. In 1994, anxious to “break the silence” and “put a face to the epidemic,” international agencies unwittingly created a market in which stories about being HIV positive could be bartered for access to limited medical resources. Being able to talk about oneself became a matter of life or death. Tracing the cultural and political logic of triage back to colonial classification systems, Nguyen shows how it persists in contemporary attempts to design, fund, and implement mass treatment programs in the developing world. He argues that as an enactment of decisions about who may live, triage constitutes a partial, mobile form of sovereignty: what might be called therapeutic sovereignty. Content: List of Illustrations Foreword, by Charles Leslie Preface PART ONE: THE AREA OF STUDY 1. The Human Setting of Healing in Lower Zaire 2. A History of Medical Pluralism in Lower Zaire PART TWO: STUDIES IN KONGO ILLNESS AND THERAPY An Introductory Note 3. Disease of God, Disease of Man 4. Strife in the Family As Cause of Child's Illness 5. A History of Madness 6. The Professional as Kinsman 7. Marriage and the Father's Blessing 8. The Clan as Patient PART THREE: THE LOGIC OF THERAPEUTIC SYSTEMS An Introductory Note 9. The Jural Status of Therapy in Kongo Society 10. Interpreting Symptoms 11. Contemporary Systems of Popular Medicine in Lower Zaire 12. Toward an Integrated Medicine Appendix A. Episodes of Case Studies Reported in Chapters 3-8 Appendix B. Herbarium of Medicinal Plants Bibliography of Works Cited Glossary-Index Abstract: Describes patterns of healing among the BaKongo of Lower Zaire in Africa, who, like many people elsewhere, utilize cosmopolitan medicine alongside traditional healing practices. This book asks What criteria determine the choice of the alternative therapies? And what is their institutional interrelationship? Read more... ''In this book, Dr. John M. Janzen describes patterns of healing among the BaKongo of Lower Zaire in Africa, who, like many peoples elsewhere, utilize cosmopolitan medicine alongside traditional healing practices. What criteria, he asks, determine the choice of the alternative therapies? And what is their institutional interrelationship? In seeking answers, he analyzes case histories and cultural contexts to explore what social transactions, decisionmaking, illness and therapy classifications, and resource allocations are used in the choice of therapy by the ill, their kinfolk, friends, asociates, and specialized practitioners.''--Publisher description (LoC). Testimonials That Bind : Organizing Communities With Hiv -- Confessional Technologies : Conjuring The Self -- Soldiers Of God : Together And Apart -- Life Itself : Triage And Therapeutic Citizenship -- Biopower : Fevers, Tribes, And Bulldozers -- The Crisis : Economies, Warriors, And The Erosion Of Sovereignty -- Uses And Pleasures : The Republic Inside Out. Vinh-kim Nguyen. Includes Bibliographical References (p. [205]-227) And Index. The story of the global response to the HIV epidemic, told from the perspective of community organizers, activists, and people living with HIV in West Africa between 1994 and 2000. Ethnography that examines the global civil rights movement demanding access to HIV treatments as it has developed in West Africa