Читать книгу Contradicting Maternity - Carol Long - Страница 17

Nombeko is an unemployed single mother who was diagnosed HIV-positive when she was five months pregnant. Her HIV-negative son was a year old when I met her. She lives in Johannesburg with her mother, although her hometown is in a rural area. She has strong roots in both traditional and urban identities. She considers herself a modern woman aspiring to Western ideals, but is also respectful and observant of traditional values and practices. Her father died when she was a child and her older brother died when she was a young adult. She has no other siblings, and speaks of herself as an only child. Her mother has an underpaid job, and Nombeko has little money. She worries that she is supposed to eat properly in order to maintain her health, but cannot afford to do so. Her mother knows she is HIV-positive, but no other family members know. She has told friends in Johannesburg, but feels unable to disclose in her hometown. Her HIV-positive status is an important part of her identity; she is eager to talk to people about HIV and, like many women interviewed, has strong desires to become an HIV counsellor. She and a friend initiated a group offering HIV education, and they were securing funding to get it started.

Nombeko is not sure how she contracted HIV. She says she only slept with the father of her baby on one occasion; she wondered at times whether she contracted HIV from him. At our first interview, he had not yet seen his son, refusing to have anything to do with him or Nombeko. Before our fourth interview, she was diagnosed with syphilis and, realising that she had previously had symptoms, wondered whether she had been HIV-positive for five years. The father of her baby comes from her hometown. In our first interview, she said he had slept with at least four other women that she knows of. Her guess was that he refused to wear a condom (as he had refused with her) and that these women may also have become infected.

She is a member of the Zionist Christian Church (ZCC), a popular evangelical church with links to African traditional practices and with a strong presence in the community. Many women I interviewed had roots in both Christianity and traditional belief systems. The ZCC brings these traditions together; e.g. the priest is also the healer. Traditional beliefs about health and illness are often believed to be a message or punishment from the ancestors or connected to bewitchment. Nombeko explained the many beliefs about HIV that were strong in her hometown. South Africans have a wide array of easily available AIDS myths to construct AIDS as somebody else’s problem. The common belief that only black people get AIDS (Robins, 2004) makes other population groups feel safer. Similarly, the belief that only promiscuous women contract AIDS makes promiscuous men feel safer (Maharaj, 2001). AIDS interacts with discourses of race, culture and gender to construct systems of safety and morality. Robins (2004: 654) lists some of the many myths in common circulation:

The blaming of AIDS on witchcraft, as well as a variety of AIDS conspiracies: ‘whites’ who want to contain black population growth; ‘white doctors’ who inject patients with AIDS when they go for tests; the CIA and pharmaceutical companies who want to create markets for drugs in Africa; the use of Africans as guinea pigs for scientific experiments with AIDS drugs; beliefs that sex with virgins, including infants, can cure AIDS; as well as beliefs that anti-retrovirals are dangerously toxic and that the lubricant in condoms is a source of HIV infection.

Nombeko was concerned about the array of myths on offer. She explained, for example, that

in our culture, they said if I can sleep with a man who’s wife is dead, I’ll get sick. They are taking HIV as like, just like that, you know, like it’s not a killing disease; they will just cure it and then go away.

Nombeko is referring to a common belief that having sex with a widowed man during his period of mourning angers the ancestors, who then make the woman sick. If she can appease the ancestors, she will be cured. At the same time, there are strong beliefs that whatever happens is God’s will, and only God can cure people. Nombeko described people who would come to her church to be cured, but at the same time, these church members believed that it was impossible for them, as God’s children, to contract HIV. According to these traditions, illness is taken to a church or traditional healer. Many consult medical practitioners as well, despite their contradictory frameworks and practices (Lund & Swartz, 1998). Nombeko believed in the power of the church and of traditional healers, but, echoing other women, was adamant that they could not help with HIV and should not be consulted. She angrily described people who say that HIV is ‘witchcraft’ and that somebody ‘didn’t like her; maybe that’s why they did this to her. You know, they are all in very big denial stage at home.’ For her, traditional medicine and Christian beliefs work, but not for HIV:

You know there, like, they said, you can hear how they say there’s someone who can cure you, whatever. I said, ‘you know, this disease, it’s like an English disease. It’s like it can’t cure by the sangomas [traditional healers], whatever.’ [She then explains that people mistake HIV for bewitchment or failure to adhere to cultural practice.] They are taking it, they want to convert it to tradition, to those things. But it can’t. It just isn’t. It’s HIV. It’s HIV, it’s a virus, it’s in your blood, you know.

Nombeko, at least in the hospital context, separates HIV from her experience with other diseases. Only medical doctors can help, because it is an ‘English disease’ that is not amenable to African cures. Surprisingly few women discussed traditional practices at length during interviews, no doubt partly because of the influence of the hospital context and my association with it. Nombeko positions herself as both traditional and anti-traditional; HIV is, however, firmly situated in the medical realm.

I met with Nombeko four times over a period of four months. She is a well-dressed and well-groomed woman who pays close attention to her appearance. She is very thin, with abrasions on her skin. She said several times that friends or acquaintances commented on how fat and healthy she appeared, which further highlighted how thin she actually was.

In her first interview, Nombeko spoke at length about her horror at the spread of HIV/AIDS. This was related to her feelings of guilt that she may be responsible for infecting women who had slept with her baby’s father – because she had not told them about her own status, rather than because she feared she had indirectly spread HIV to them. Respondents seldom verbalised thinking of the infection of other women through their partners; Nombeko was atypical in voicing such concerns.

The second interview started with my asking her how things were going with her. She replied:

Oh, it’s like now, I think I can deal with it now. Ja. But some days I can, some days I cannot; but these days that I can say ‘thank God I can’, it’s like when I’m talking to somebody, like you, like that lady I’m working with, it’s better. But I can spend the whole day not talking to anybody; it’s like eating me inside.

Nombeko’s opening assertion ‘I think I can deal with it now’ seems strong, but it immediately wavers into ‘it’s eating me inside’. The struggle between being ‘brave’ (a word she frequently used) and not coping characterised the narrative structure of her interviews, connected here to her interactions with other people. She spoke about the support group she was starting – ‘You know, it means a lot to me, it’s like I’m doing something … I even feel like a[n HIV-]negative person’ – but soon switched to telling stories about watching people dying. Sickness and death were more present in this interview than the first, as were statements about the need for courage and acceptance. I came away from the interview feeling that her statements of hope were haunted by dead and dying bodies. Discussions of motherhood felt as though they were somehow separate, but couldn’t be separated fully. For example, she imagined telling friends that she was HIV-positive and not being believed, because her baby was ‘healthy, you know, nice and everything, how can I be positive?’ – as if HIV and motherhood were mutually exclusive.

Before our third interview, the hospital had contacted Nombeko to request another blood test to confirm her son’s negative status. She had not expected another test, and felt that the closure that she had reached regarding her son’s status had been reversed: ‘It’s like it’s repeating itself all over again.’ She spoke more, however, about her own HIV-positive status than her child’s status in the interview, and I wondered whether the sense of regression she described regarding her son’s status had underscored the fact that she was HIV-positive. There was more discussion in this interview about sickness and death, often in the context of discussions of broader social systems (such as the church, traditional healing and the hospital). If the central metaphor in the first interview was that of the spread of HIV, the central metaphor here was of a social system trying, and failing, to ignore death. Towards the end of the interview, she said that her mother had found a new boyfriend. Nombeko was terrified that he would infect her mother, but was too scared to discuss this with her, because it transgressed culturally acceptable relations of respect between mothers and daughters. She was worried that if her mother became infected, she would not be able to look after Nombeko when she became sick, or Nombeko’s son when Nombeko died.

In the fourth interview, events had intervened again to foreground sickness and death. Nombeko had been diagnosed with syphilis and told that it may become neurological if she did not follow treatment. This provoked anxiety about her body and, in conjunction with the request for a further HIV test for her son, about his body. Discussion of monitoring the body was common among most respondents, and had been present in previous interviews with Nombeko, but was strongly expressed in this interview. The interview occurred before she was due to go back to her rural home, and she was worried about seeing her baby’s father and fearful of encountering people dying of AIDS at home, where she felt she could not disclose her own status for fear of rejection. The interview ended on a triumphant note as she told me she had successfully spoken to her mother, asked her not to have sex without a condom and explained her concerns. Her mother was proud of her, as was Nombeko, for having the strength to talk.

Nombeko had wanted a final interview, but could not afford to return to Johannesburg. When we spoke on the telephone, she said she had been reunited with her son’s father, at first as a coerced reunion, but then he had become progressively more open and she was optimistic about their relationship. Her son’s negative status was confirmed. She had been sick, and said she had lost weight. When we ended our last telephone conversation, she laughingly said that I should not worry, because she would still be alive when I returned to South Africa. I put the telephone down with the sinking feeling that perhaps she would not be.