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A Sent Sickness and the Role of Human Agency: “AIDS and Accusation” in Haiti and North America

December 14, 2011

by Fiorenzo Conte

AIDS and Accusation by Paul Farmer is a  fascinating exploration of the social responses to HIV/AIDS at the onset of the epidemic (in the early 1980s) in North America and the Caribbean. The most predominant amongst these responses is accusation i.e. the allegation that human agency played a role in the sickness. Seen from this perspective the response to AIDS gives insight into the narrative and discursive production which evolve around this new disease. By exploring these constructs the real goal of Farmer is not to ascertain whether or not such representations are true but what they tell about the underpinning power relationships which shape both the development of the disease and its understanding by the people affected by it. By so doing, the merit of the book in my view is that it unveils not only the causes of such narratives but also the function that such representation play in the conservation of or the fight against the status quo.

The first form of AIDS-related accusation is the one against Haitians in North America. In 1983 the Center for Disease Control referred to Haitians as a high-risk group i.e. a group at risk of contracting HIV. It drew this conclusion despite the scanty evidence that existed at the time about how recent Haitians immigrants showing opportunistic infections had caught the disease. Although the CDC was careful in saying that classifying Haitians as a risk group did not imply that the majority of Haitians were at risk of AIDS, the popular media and part of the scientific community were quick to infer a causal relationship from the fact that Haitians immigrants showed signs of AIDS and the onset of the epidemic in North America. As a result, Haitian became synonym with “AIDS carrier”. The most striking feature of the resulting epidemic of discrimination was that it went on despite careful studies by Haitian scientists showed that the syndrome was new to Haiti and that the main risk factor among HIV positive people in Haiti had been a sexual intercourse with gay North American tourists. As Farmer brilliantly explains, what bred this form of accusation was not the epidemiological evidence available but the preexisting folk models of Haitians in the North America imaginary. This model described the typical Haitian as a black person who was actively engaged in voodoo rituals and countless sexual relationship. If HIV is to be endemic in Haiti- so the argument went – then there was no doubt that such factors fueled the epidemic.  So if the cause of this form of AIDS-related accusation were exoticism and racism what was the function of such representation? Resorting to the exotic serves to distract the North American audience from the fact that what caused HIV in Haiti were appalling rates of unemployment which unleashed a mushrooming prostitution industry in which poor people engaged in sex with infected North American gay tourist. Such representation serves the purpose to push into the oblivion the fact that the extreme poverty was not endemic to Haiti but it was the result of the skewed political economy of the Caribbean – in which the US played a major role. Such narrative of Haitian as AIDS vector served in other words the function to blame the victim.

The second form of AIDS-related accusation was crafted by Haitians and it described AIDS as part of an American plan to get rid off of the too many Haitians, who were not longer needed in the American  reassembling plants in Haiti. This allegation is inscribed in a long history of North American interference with Haiti which stretches back to 1915 with the American occupation of Haiti, the arbitrary expropriation of land and the brutal crackdown of the peasant resistance to the occupation. Given this history of exploitation and unequal exchange between Haiti and the US, a narrative of conspiracy in which the perpetuators of violence and exploitation becomes the agent behind the disease serves the function of counteracting and counterbalancing the blame-the-victim narrative which ignited so much discrimination of Haitians in North America.

The third form of AIDS-related accusation is related to the sorcery –locally called maji – in the Haitian village of Do Kay. As Farmer explains, the backdrop of this form of sorcery is a fierce competition in the context of great scarcity, whereby every person who was successful in achieving an economic advancement was perceived to have done so at the expense of the other. For this reason AIDS is also known as the jealousy sickness. The proximate motives behind such forms of accusation are in fact always related to a zero-sum struggle for survival (pending debt to someone else, a reply to an aggressive magic previously received, an argument, the accumulation of wealth in a context of widespread poverty). The latter motive of the accumulation despite widerspread poverty reveals the function of such sorcery: those who gain wealth without sharing with their impoverished neighbors are to be sanctioned in some form. In other words, the sorcery serves the purpose of punishing those who breach the obligation of sharing with and helping others. It serves the function of reinforcing the equality within a society where equality has come to be narrowly defined as shared poverty in rural Haiti.

In summary, when AIDS narratives are investigated they reveal the search for the human agent behind the sickness. The identity of the blamed is predicted by the position of power of the person accusing. So the North American accused Haitians of carrying the disease in the country despite evidence showed the contrary thus highlighting their power to blame the victim. Haitians in both North America and Haiti conceived conspiracy theories to counteract such blame. At the same time villagers in rural Haiti saw the advent of sida as a consequence of the failure to share the accumulation of even a limited wealth. Given their position of powerlessness such forms of accusation did not target the North American tourists or local elites but only other poor people relatively better off. In other words poor people were fighting against each other in a fashion which determined not only the geography of blame but also the patterns of transmission of the new disease amongst Haitians.

One Comment leave one →
  1. December 26, 2011 2:11 pm

    Similar things happen in the African context too, particularly in Southern Africa. AIDS is (or was, great strides have been made) seen as caused either by witchcraft or seen as a punishment for immorality. I wish I had the book with me to quote verbatim, but John Iliffe spends some time in his excellent history of AIDS in Africa:

    Interesting to see how similar patterns emerge throughout the world – or is it just the diaspora? I’d think it would be a universal tendency among humans. Especially when faced with incurable diseases such as AIDS, dealing with the matter is a lot easier if we blame the victims – it gives a sense of order and power in the face of a looming threat.

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