“Sending Sickness: Sorcery, Politics, and Changing Conecepts of AIDS. In Rural Haiti” was written by Paul Farmer in 1990 for (and published in) Medical Anthropology Quarterly. The article mainly aims to make clear how perceptions of AIDS existed. And changed in Haiti over time. But also poses questions to anthropologists about. What the field of medical anthropology can do to actually assist with outbreaks of AIDS and other diseases. As the article is primarily documentarian. It doesn’t challenge many preexisting beliefs directly. And thus doesn’t have any enemies, but is also unlikely to especially make the author any friends. Citations are primarily from Haitian residents and used to make clear their thoughts about AIDS.
The article is primarily concerned about the rural area of Do Kay in Haiti. Though the ideas expressed by the people in Do Kay range in scope from the local to the national and even international scale. The Study was a series of interviews that took place from 1983, before the AIDS epidemic in Haiti, to 1990. The primary comparison in the study is between the different views. And models of AIDS that emerged in Do Kay before the epidemic and as it began to spread in Haiti.
The primary goal of the article is as a documentary, and as such does not explicitly present an argument. However, Farmer does ask questions and frame the article in such a way as a to argue that medical anthropology may have the ability to take an active role in helping deal with epidemics and diseases such as AIDS.
The primary way this argument is delivered is through narratives about how our own views expressed in the US (which US anthropologists in general are most able to affect) in turn can affect international views about disease; for example narratives in the US about Haitians being “more susceptible” to the disease lead to Haitian narratives blaming or suspecting the US of being responsible for the spread of AIDS in Haiti. As such, it is suggested that changing our own narratives about international issues of disease can in turn lead to different (and preferably quicker and better- organized) responses in other countries.
Data was gathered through a series of interviews from 1883 to 1990. Interviewees were asked how AIDS (known as sila in Haiti) spread, what caused it, and how it could be prevented. The purpose of the interviews was to determine what the local model for how AIDS worked was in Haiti, if there was any consensus at all. Of course, asking such questions requires the assumption that interviewees had enough information to create a model (and in early interviews it was shown that this assumption was somewhat flawed, as interviewees had little to say about sila since they had not encountered much information about it, only rumor).
In terms of categorization, Farmer mostly seemed to group people (both spacially and temporally) in terms of their exposure to AIDS/sila; he explains early on that the primary difference between people’s narratives depended less on ethnographic matters or social status and more on how close people were to others that had the disease and how long rumors and information about it had been spreading. However, giving additional details of the interviewees’ social statuses could perhaps strengthen this claim, as without it we are expected to merely trust Farmer’s judgement.
The passages that spoke about the “Rhetoric of complaint” (pg. 11-12) were very interesting to me, as it inspired me to take a closer look at our own rhetoric of complaint here in the US. In Haiti, (and many other countries) many would be afraid to discuss medical issues lest they be interpreted as political complaints, or vice-versa: medical and political complaints would become essentially inseperable.
This makes me look at current complaints (even my own!) about the US medical system and wonder if we have a situation at once similar and opposite: rather than medical complaints attaining political implications, I wonder if many political complaints might actually have attached medical causes. Take, for example, the usage of the phrase “Obamacare” as a disparaging term used to damage the reputation of the democratic party and Obama in particular; how much of the usage of this phrase is due to legitimate political concerns and how much of it due to the predisposition to politicize medical complaints?
Two open-ended questions:
To what degree does the difference between the Haitian view of the spread of AIDS differ to western medicinal view; and more importantly, is there a way this difference can be beneficial? (For example, does the view that sila can be sent to a neighbor out of jealousy create a tool to unite the Haitian poor, or does it instead divide them and obscure the cause of the spread of AIDS, and thus cause more harm than good?)
In what ways could medical anthropologists taken a more active role to reduce the effects of AIDS in Haiti (or in the world in general)?
