Travis Kavulla on AIDS relief and culture
Aids Relief and Moral Myopia by Travis Kavulla is definitely worth a read for anyone interested in the intersection between ‘Western development’ and local cultures.
Kavulla articles addresses how and why current Western approaches to AIDS aren’t working in Africa due to differing cultural approaches to problem solving.
Whereas in the West we have dealt with AIDS with primarily technical solutions like condoms and ARVs (which have worked!), Kavulla writes that we can’t just transplant to Africa and expect good results, as it fails to take into account the non-Western approach to problems which involves more than just material/technical solutions.
He argues that we need to understand the role spirituality plays in African societies to be able to really tackle AIDS, and that we need to be willing to advocate the altering of behaviour rather then just rely on ’scientific’ or technical solutions to problems.
Some good quotes:
The lesson the public-health community derived from this experience was that widespread sex and drug use is an immutable fact of life. In this light, the main task of the public-health community was and is to give risky behaviors an appliqué of safety, not to seek to alter behavior fundamentally, lest stigma and alienation result. This attitude is rigorously enforced today in such circles; at the 2007 worldwide conference on AIDS in Mexico City, a number of scientists emphasizing behavioral change over condom use were actually shouted down. …
Go to any district hospital in Africa today, and you will find two clinics: one for AIDS—built, funded, and perhaps even staffed by the donor community—and the other for everything else, supported by whatever invariably cash-strapped and corrupt government presides. Bruce Dahlman notes, “Medical officers in either clinic will be seeing the same conditions, because those HIV patients come in with colds and flus and everything else, but they’ll be treated as a separate category because of their status.” So, in addition to the prospect of being medicated for life, Africans who develop AIDS and need intensive treatment become taboo figures—the lepers of this century, you might say, though exquisitely looked after by comparison, much to the resentment of those who must make do with regular health care.
It’s a great read to see how important our cultural blinders can be when trying to ‘help’ others.
There is an obvious danger of condescension and hypocrisy in “telling Africans to abstain and be faithful”, but I think Travulla’s argument is more nuanced then this sort of paternalism. It recognises that for an approach to work it needs to be rooted in the local culture and make sense to the people its designed to help. And I think all to often Western assistance fails because it just doesn’t make sense outside of the donor country.
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