Publication: Oceania
Publication Date: 01-MAR-07
Delivery: Immediate Online Access
Author: Lepani, Katherine
Article Excerpt
INTRODUCTION
This kind of sexual behaviour [having multiple partners] is part of our custom so it is not really surprising to us about AIDS, because maybe we already know this disease through sovasova. Because we have the clan system and we follow it in our sexual behaviour and if we don't follow it we get sick. So maybe people from other places don't understand about the clan system and they have too much mixing of the same kind and that is how this virus has spread and made so many people sick. But here we know this sickness and we have treatment. We can control the spread. Trobriand man, aged mid-30s, 4/11/03
HIV is far greater than a microscopic pathogen. The human immunodeficiency virus 'transcends the boundaries of biomedicine' (Huber and Gillapsy 1998:191) as it moves through cultural landscapes and becomes visible in the social body, configured by discourses of sexuality, morality, fear, risk, and disease, and the meanings people bring to bear on the information they receive. Concurrent with the persistent spread of HIV infection throughout the world is the proliferation of multiple ways of comprehending HIV and AIDS as different knowledge systems and discourses converge and interact, producing an 'epidemic of meanings or signification' (Treichler 1999:11).
The migration of predominantly western models and moralities about disease causality, sexuality, and sexual behaviour has enormous influence on the interpretive process of making sense of HIV and AIDS in diverse cultural contexts. The application of external models of meaning potentially affects the capacity for people to articulate and clarify local understandings and form cognitive links with new information. The discursive production of HIV and AIDS is able to rupture deep layers of cultural knowledge and expose established forms of meaningful practice to new evaluations. For example, Philip W. Setel's ethnography of the epidemic in Northern Tanzania demonstrates how 'the disordering effects of the epidemic are simultaneously creative of new meanings and revealing of long-standing values which surround social reproduction' (1999:16). The discursive production of meanings also underscores how perceptions and understandings of H1V and AIDS change over time as experience of living with the effects of the epidemic unfolds (Farmer 1990, 1992). Additionally, the question of temporality has a direct bearing on eliciting perceptions through the process of research, as Paul Farmer (1992:287) points out: 'Investigation of evolving understandings of AIDS calls attention to the problems inherent in studying cultural meaning while it is taking shape.'
Drawing on ethnographic fieldwork in the Trobriand Islands of Milne Bay Province, Papua New Guinea, this article examines the discursive dimension of the epidemic, and the dialogical mediations between a specific cultural model of sexuality and disease and received representations of H1V and AIDS. (1) The views presented are a representative sample of the perspectives of adolescent and adult men and women obtained during unstructured interviews, group discussions, and informal conversations. While mindful that 'the way the epidemic is brought to people's attention will be the critical determinant of how they will respond to it' (Reid 1994:1), my concern here is how an existing cultural model provides an interpretive framework for making sense of new phenomena. The popular abstraction of AIDS as a looming threat from beyond the islands provides a pivotal reference for the assertion of Trobriand ideations of sexuality, morality, and disease. The Trobriand concept of sovasova, or chronic illness that manifests from the breach of clan exogamy when members of the same matrilineal clan have sexual relations, is a persuasive and problematic form of cultural knowledge that directly influences comprehensions of HIV and AIDS in the Trobriand context. The topic of sovasova emerged unprompted in nearly every scheduled interview session held during the research. The consistent association people draw between sovasova and AIDS reflects a logical attempt to resolve the uncertainty about the presence of HIV in the Trobriands, and temper the seemingly paradoxical representation of AIDS as a new disease of sexual risk that has no available treatment or cure. (2) That an introduced and novel disease has no treatment or cure is antithetical to the traditional model of medicine, and contradicts popular notions of modern biomedicine as well, commonly perceived as having a diagnostic regimen of drug treatment for every known disease.
I begin with a brief overview of the factors influencing how the presence of HIV and AIDS is taking shape in the Trobriands. I then distill some of the germane elements of Trobriand ideology on kinship, exchange relations, and sexuality to provide a conceptual framework for considering the significance of sovasova in maintaining relations of difference. Then I present a description of sovasova and offer a comparative analysis of sovasova and HIV and AIDS to consider points of convergence and distinction, and to look specifically at how Trobrianders' conceptual engagement with HIV and AIDS is mediated by cultural knowledge and social practice. Finally, I discuss the implications of cultural representations of sexuality and illness for effective responses to the challenges of a localised HIV epidemic in the Trobriands.
THE PRESENCE OF HIV IN THE TROBRIANDS
When we got the awareness, we are all afraid of AIDS, so we are asking, do you have any ideas to help us see this thing, to help us with our feeling about AIDS, to help us understand about AIDS so we won't be afraid? Trobriand woman, aged mid-50s, Kaituvi Village, 19/9/03
The presence of HIV in the Trobriands, with a population of nearly 30,000 people, (3) remains largely abstract, made known primarily through how people are talking about the virus and the syndrome. To date, few Trobrianders have direct experience with the clinical and social manifestations of diagnosed HIV sero-positivity. Estimations of the number of people living with HIV in the Trobriands are highly speculative, as is the case in most rural and remote areas of Papua New Guinea, due to limited primary health services and diagnostic resources, and the unavailability of HIV voluntary counselling and testing services. There are several non-confirmed cases of people returning home to the Trobriands after having tested HIV-antibody positive in urban centres, and a few anecdotal reports of people dying from HIV-related illness. AIDS is speculated to be the probable cause of death in a number of instances, especially if the deceased suffered prolonged, degenerative illness after having travelled or resided outside the islands. In 2001, the first case of confirmed HIV was reported by the Losuia District Health Centre on Kiriwina (the main island in the Trobriand group) after serum testing was conducted at the Central Public Health Laboratory in Port Moresby. The district Health Extension Officer (HEO) ordered the test after the patient failed to respond to drug treatment for diagnosed tuberculosis. The HEO called this the 'first home-grown case' because the patient had never travelled outside Kiriwina (T. Elliot, HEO, pers. comm.).
The conundrum of HIV visibility holds the challenge of soliciting preventive action before the presence of the virus becomes evident in a way that compels an immediate response. Yet the presence of factors associated with HIV susceptibility suggests that the Trobriands potentially faces a critically serious epidemic unless prevention efforts are comprehensively put into place. These factors include early onset of sexual activity; frequent acquisition of new sexual partners including concurrent partners; high prevalence of sexually transmitted infections (STI); (4) and low levels of condom use. Further social and economic factors compound HIV susceptibility, including increased mobility between the Trobriands and urban centres; intensified commercial trade networks through maritime travel; limited income earning opportunities within the local economy; and greater population pressure on a finite resource base.
Not withstanding the indeterminacy of HIV prevalence in the Trobriand population, the discursive presence of the epidemic is palpable. Talk about HIV and AIDS has gained prominence in local discourse about contemporary concerns and issues, and communication about HIV risk and prevention has become increasingly common through various community-based awareness activities, training workshops, and through informal flows and exchange of information. Increased political and media attention on the escalating epidemic in PNG, and various awareness campaigns orchestrated at the national and provincial levels, have significant influence on how HIV and AIDS are represented and discussed at the local level. Awareness information modelled on biomedicine and epidemiology carries moralistic interpretations, amplified by an amalgamation of Christian and traditional cosmological beliefs. Throughout the country, including the Trobriands, churches provide the main organisational framework for facilitating HIV and AIDS awareness training at the community level, with variable results in terms of the willingness to address sexual practice and the use of condoms for protection against viral transmission (Luker 2004:5, 10). The popular discourse of AIDS persistently represents HIV infection in terms of sexual deviance and excess, a bias reinforced by the epidemiological categories of 'risk groups' and 'risk behaviours.' Fear of death pervades the tone of communication and incites responses of stigma, shame, and blame as people struggle to comprehend a sickness that has no available treatment or known cure.
In contrast to areas in PNG where moralistic reactions to the epidemic thwart communication about sexuality, sexual behaviour, and HIV prevention (Eves 2003; Hammar 2005), the topic of HIV and AIDS has been largely received in the Trobriands with candid interest. People express a collective concern to overcome the fear of the unknown and address the implications of an impending epidemic. I suggest this response is due in part to perduring Trobriand cosmology, which values sexuality as consensual and pleasurable practice that sustains the flows of reciprocity between clans, maintaining the relations of difference that activate social reproduction. Christian doctrine has not generated a repressive attitude to sexuality nor has it supplanted traditional ideals of sexuality. The existing cultural vocabulary facilitates the capacity to talk about sex and sexual relations and to contemplate interconnections between sexual practice and disease etiology.
Yet the spectre of AIDS as a 'killer disease' wrought by sexual deviance and excess holds tensions and contradictions in relation to the Trobriand model of sexuality and disease. The received discourse of HIV and AIDS persistently...
NOTE: All illustrations and photos have been removed from this article.
More articles from
Oceania
Introduction: HIV and AIDS in rural Papua New Guinea, 01-MAR-07
Sovasova and the problem of sameness: converging interpretive frameworks for making sense of HIV and AIDS in the Trobriand Islands, 01-MAR-07
'Turning sex into a game': Gogodala men's response to the AIDS epidemic and condom promotion in rural Papua New Guinea., 01-MAR-07
Looking for additional articles?
Click here to search our database of over 3 million articles.
Looking for more in-depth information on this industry?
Click here to search our complete database of Industry & Market reports by text, subject, publication name or publication date.
About Goliath
Whether you're looking for sales prospects, competitive information, company analysis or best practices in managing your organization, Goliath can help you meet your business needs.
Our extensive business information databases empower business professionals with both the breadth and depth of credible, authoritative information they need to support their business goals. Whether it be strategic planning, sales prospecting, company research or defining management best practices - Goliath is your leading source for accurate information. |
