Читать книгу Contradicting Maternity - Carol Long - Страница 15

Pumla, unemployed, conducted an interview with me when she was eight months pregnant and again when her son was three months old, before she knew his status. Her appearance was neat and her dress demure. She did not see herself as a ‘modern woman’, as did Hlengiwe. Pumla was diagnosed HIV-positive when she was three months pregnant. At the time, she was living with her boyfriend of ten years, the only person with whom she had had a sexual relationship. This relationship was stable, but violent; she described how he was hypervigilant of her actions and showed me a scar on her face where he had hit her with a gun. She was not the only woman to describe domestic violence: South Africa has one of the highest domestic and sexual violence rates in the world. Pumla had been concerned that her boyfriend had other sexual partners and, before being diagnosed, had thought about asking him to use a condom. However, she was too scared to do so. Strebel (1997) suggests that South African women are caught in a paradox in which they are expected to take responsibility for safe sex, but are often powerless to do so. The ‘good’ woman should avoid becoming HIV-positive by maintaining self-control, self-discipline and responsibility (Sacks, 1996). In everyday negotiations, however, expecting women to take responsibility for their sexuality ignores the asymmetry of heterosexual relationships (Kippax et al., 1990). This has particular resonance in Africa, where women have little access to sexual negotiating power (Lawson, 1999). A woman who requests condom use, for example, is likely to be accused of being HIV infected or promiscuous, or of accusing her partner of infidelity (Santow, 1995), the consequences of which can be violent and can lead to economic hardship (Strebel, 1992). This is precisely what Pumla was scared of. Urging South African women to ask their men to use condoms ignores male suspicion of condoms (Maharaj, 2001), as well as the interaction between male power and discourses of love for women, where women may accept what men want because they love them (Hoosen & Collins, 2004). Further, AIDS campaigns often reinforce the sanctity of faithful heterosexual relationships (Seidel, 1990) without acknowledging double standards in which male promiscuity is acceptable or situations in which multiple sexual partners may signify masculinity (Walker, Reid & Cornell, 2004). In circumstances such as these, a woman’s faithfulness, such as Pumla’s, to her partner therefore often fails to protect her from HIV infection (Lawson, 1999).

When Pumla told her boyfriend that she was positive, he ‘chased’ her away, ‘and he said to me, “if you call me and accuse me of that, you’re wasting your time. You can see me that I’m happy, I’m healthy, I’m okay”’. He accused her of becoming infected through ‘sleeping around’ and denied any possibility that he may be infected. He had seen the baby once since he was born, but denies paternity.

Left with nowhere to live, Pumla approached her mother and disclosed her status. At first her mother was supportive, but, when her baby was a few days old, told her to leave and not come back: ‘I’m finished with your child.’ Pumla thinks that her mother assumed that she and her baby would become sick immediately and did not want the scandal associated with an AIDS-related death, that her mother blamed Pumla for becoming infected, and that ‘it’s my fault, because I didn’t listen to her’. When I asked what her relationship with her family had been like before her diagnosis, she said that she was ‘very, very close’ to her mother:

You see, I was working and I didn’t have a baby, you know. It was my mother, and my mother she is a pensioner, and my brother and my sister, né, who stay with my mother. So my mother, she loved me very, very, very much, because each and everything that I do, when I buy groceries, I buy groceries for my mother, because I’m working and I have money. Every time when I bought something, it’s for my mother, because I know that my brother he’s drinking, you see all these things, and my sister can’t help my mother. Everything was very, very good; me and my mother got on well.

This illustrates the cultural importance of supporting one’s family, a value shared by most participants, whether they lived with family or not. For Pumla, however, this support was not reciprocated and she was forced to live on her own. This was particularly hurtful for her, given the culturally accepted practice that a woman lives with her mother after a baby is born so her mother can help with the first stages of childrearing and protect her in the maternal home. Even women who lived with their partners were expected to go to their mothers’ homes for a period post-partum. In reality, however, few women were able to do this, either because their mothers lived far away, were old or had died; because they had difficult relationships with their mothers; or because they were stigmatised and rejected because of their HIV status, as in Pumla’s case.

Although some women were supported after disclosing their HIV status, all the women interviewed experienced some stigma. This was sometimes a direct result of disclosing their status, but was sometimes indirect. Numerous examples were cited of women overhearing or participating in conversations about HIV with people who did not know that they were positive and being hurt by the prejudiced comments people made. Pumla describes a typical example in which this prejudice is combined with assumptions about motherhood:

Whenever these people they talk about HIV and AIDS [and] they think people [are] with HIV, people like to talk very, very, very bad things about HIV people. Sometimes they say, ‘oh, I don’t like these people. If maybe somebody can come into my house and say they’re HIV-positive, I can say, ‘no you must go’. Then I said to this person, ‘if I can tell you that I’m HIV-positive, what are you going to do?’ He said to me, ‘no, I can see that you are clean. You’ve got a small child. If you were having HIV, people with HIV, the children they die, so I can see your baby is growing normally and you’re healthy too.’

The assumption here is that mothers who are ‘clean’ cannot be ‘bad’ or HIV-positive. Pumla describes becoming increasingly expectant of being rejected on the basis of her HIV status. She felt stigmatised against, even by the hospital. She described telling an HIV-positive friend about a recent conversation with her doctor, who warned her not to touch her baby, even though medical opinion is virtually unanimous that you cannot give some HIV by touching them:

I said, ‘[the doctor said,] do you know that if you, you are positive, you mustn’t kiss your child, mustn’t sleep with your child with you’. She said to me, ‘hau!’ Then I said, ‘the doctor said even if you give them food, you mustn’t taste anything’.

HIV transmission was a primary concern for many. The women I interviewed, including Pumla, were well informed about modes of transmission. Many kept newspaper clippings and voraciously watched television programmes in order to keep themselves informed. They understood that HIV can be transmitted during pregnancy and labour or through breast milk. Similarly, they knew that normal physical contact is perfectly safe. Many described the social prejudice that physical contact could be contagious. Pumla knew that kissing her baby or sharing food did not put her baby at risk, but doubted her knowledge in the face of medical opinion. It is unclear whether a doctor actually said this; and it is unlikely that the doctors at the treating hospital would have expressed this stigmatised view, but the doctor she described was at a local clinic. In a sense, it is immaterial whether this was actually said or not. For Pumla, this idea simultaneously expressed her anger at being stigmatised and her fears of infecting her baby.

She also described attempting to gain support from her church. Christianity was important to her, as to many participants, and so she spoke to the priest’s wife. Having experienced prejudice, she framed it carefully: ‘I didn’t say I’m positive to the lady. I say they think that I might be positive.’ In her view, her wariness was justified; she thought that the priest’s wife had betrayed her confidence:

Sunday, when I go to church, the priest was busy preaching about people who don’t respect their mothers and some of them they are HIV-positive; yes, you see, if you’re HIV-positive, you’ve done bad things to your body. God shows that you, you see [inaudible]. So this lady told him and that’s why he was preaching like that.

In a context where HIV awareness is visible on television, in newspapers, in schools and on billboards, the ostracism that circulates in the face of HIV is striking. Pumla described stigma in her social environment and also described how she cherished a television advertisement showing a white man who had lived with HIV for 19 years. Pumla felt particularly trapped by her status and described feeling self-anger and self-hatred for becoming HIV-positive. The contradiction that it wasn’t her fault, but that she was to blame, a contradiction shared by other women, was one that she was unable to resolve, and one that was echoed in the social environment.