Elizabeth Mills

Introduction: contextualising "rights" in sexual and reproductive health.

The idea for this supplement arose from discussions among a set of research partners associated with the Realising Rights Research Programme Consortium (RR RPC), an international partnership funded by the UK Department for International Development from 200510 that focused on neglected areas of sexual and reproductive health and rights (SRHR) [1]. In the Consortium, work on rights has been concerned with ways of bridging the gap between international legal human rights frameworks as applied to SRHR, and how these play out for actual people ‘on the ground’ .W e noted that there was a well-developed international language of human rights in relation to sexual and reproductive health, accompanied by significant international advocacy efforts stretching back several decades [2-4]. However, SRHR remained controversial and contested; sexual rights in particular are poorly understood by many policy actors, they are not easy to operationalise ‘downstream’ in policies and programmes, and their place and relevance in people’s day to day lives have been much less explored [5-7]. The papers in this volume are one contributi on to the task of laying out why it is important to fill this gap and what the analytical challenges are in doing so. We decided, therefore, to focus our thematic work on rights on the challenges of contextualising and operationalising the concept in different local and national domains. The aim was to start from the perspective of lived experience, rather than from an

Biopolitical precarity in the permeable body: the social lives of people, viruses and their medicines

Abstract This article is based on multi-sited ethnography that traced a dynamic network of actors (activists, policy-makers, health care systems, pharmaceutical companies) and actants (viruses and medicines) that shaped South African women’s access to, and embodiment of, antiretroviral therapies (ARVs). Using actor network theory and post-humanist performativity as conceptual tools, the article explores how bodies become the meeting place for HIV and ARVs, or non-human actants. The findings centre around two linked sets of narratives that draw the focus out from the body to situate the body in relation to South Africa’s shifting biopolitical landscape. The first set of narratives articulate how people perceive the intra-action of HIV and ARVs in their sustained vitality. The second set of narratives articulate the complex embodiment of these actants as a form biopolitical precarity. These narratives flow into each other and do not represent a totalising view of the effects of HIV and ARVs in the lives of the people with whom I worked. The positive effects of ARVs (as unequivocally essential for sustaining life) were implicit and the precarious vitality of the people in this ethnography was fundamental. However, a related and emergent set of struggles become salient during the study that complicate a view of ARVs as a ‘technofix’. These emergent struggles were biopolitical, and they related first to the intra-action of HIV and ARVs ‘within’ the body; and second, to the ‘outside’ socio-economic context in which people’s bodies were situated.

“When the skies fight”: HIV, violence and pathways of precarity in South Africa

Abstract Based on multi-sited ethnographic fieldwork in South Africa, this article explores the skies that fight, the proverbial lightning strikes that bring HIV into women’s lives and bodies. Departing from earlier studies on ARV programmes in and beyond South Africa, and broadening out to explore the chronic struggle for life in a context of entrenched socio-economic inequality, this article presents findings on women’s embodiment of and strategic resistance to structural and interpersonal violence. These linked forms of violence are discussed in light of the concept of precarity. Across two sections, the findings trace the pathways through which precarity entered women’s lives, drawing on verbal, visual and written accounts collected through participant observation, participatory photography and film, and journey mapping. In doing so, the ethnography articulates the intersection of structural and interpersonal violence in women’s lives. It also reveals the extent to which women exert a ‘constrained agency’, on the one hand, to resist structural violence and reconfigure their political relationship with the state through health activism; and, on the other hand, to shift the gender dynamics that fuel interpersonal violence through a careful navigation of intimacy and independence. Résumé Sur la base d’un travail ethnographique de terrain sur plusieurs sites en Afrique du Sud, l’article étudie les cieux orageux, la foudre proverbiale qui fait pénétrer le VIH dans le corps et la vie des femmes. S’éloignant d’études précédentes sur les programmes de traitement antirétroviral en Afrique du Sud et au-delà, et souhaitant étudier la lutte chronique pour la vie dans un contexte de profondes inégalités socio-économiques, cet article présente des résultats sur la traduction par les femmes de la violence structurelle et interpersonnelle et la résistance stratégique qu’elles lui opposent. Ces formes liées de violence sont examinées à la lumière du concept de précarité. Dans deux sections, les résultats retracent les voies par lesquelles la précarité est entrée dans l’existence des femmes, se fondant sur des récits oraux, visuels et écrits recueillis par l’observation des participantes, les photographies et les films participatifs ainsi que la cartographie des parcours. Ce faisant, l’ethnographie articule l’intersection de la violence structurelle et interpersonnelle dans la vie des femmes. Elle révèle aussi dans quelle mesure les femmes exercent une «action contrainte», d’une part, pour résister à la violence structurelle et reconfigurer leurs relations politiques avec l’État par le biais du militantisme pour la santé et, de l’autre, pour réorienter la dynamique de genre qui alimente la violence interpersonnelle par une navigation attentive dans l’intimité et l’indépendance. Resumen Basado en trabajo de campo etnográfico realizado en múltiples sitios en Sudáfrica, este artículo explora los proverbiales relámpagos que traen VIH a la vida y el cuerpo de las mujeres. A raíz de estudios anteriores sobre programas de ARV en Sudáfrica y otros países, y explorando la lucha crónica por la vida en un contexto de desigualdad socioeconómica arraigada, este artículo presenta hallazgos sobre la manifestación de violencia estructural e interpersonal en las mujeres y su resistencia estratégica a la misma. Estas formas vinculadas de violencia son discutidas en vista del concepto de precariedad. En dos secciones, los hallazgos siguen las rutas por las cuales la precariedad entró en la vida de las mujeres, basándose en relatos verbales, visuales y escritos recolectados por medio de observación participante, fotografía y película participativa, y mapeo de las experiencias de las mujeres. Al hacer esto, la etnografía expresa la intersección de la violencia estructural e interpersonal en la vida de las mujeres. Además, revela en qué medida las mujeres ejercen ‘agencia restringida’, por un lado, para resistir la violencia estructural y reconfigurar su relación política con el estado por medio del activismo en salud; y, por otro lado, para cambiar la dinámica de género que alimenta la violencia interpersonal, mediante la cuidadosa navegación de la intimadad y la independencia.

Discursive Silence as a Global Response to Sexual Violence: From Title IX to Truth Commissions

A pattern of personal and political silence in response to sexual violence is evident across societies, despite significant cultural, political, and social differences. Drawing on Foucault’s concept of discourse as a tool that can shed light on the hidden workings of historically contingent social systems that produce forms of knowledge and meaning, we argue that the logics that are built into laws governing national responses to sexual violence draw attention to the ways that these logics structure social relations between sexual violence survivors and society, masking some experiences and bringing others to light. Following Marianne Constable’s analysis of silence and the limits and possibilities of modern law, the manuscript explores the ways in which strategies of silence in the face of sexual violence might lead to novel approaches for pursuing justice for survivors outside of positivist legal frameworks. We also draw on critical feminist perspectives directing legal scholars to pay careful attention to non-legal discourses in developing analyses and responses to sexual violence. The manuscript develops its central arguments through an examination of two dramatically different cases: (a) Title IX as a mechanism for responding to sexual violence on college campuses in the United States; and (b) the South African Truth and Reconciliation Commission’s efforts to pursue transitional justice vis-à-vis gender and sexual violence in post-apartheid South Africa. There is, in other words, a silence about who suffers this affliction that further silences women. Silences build atop silences, a city of silence that wars against stories. A host of citizens silencing themselves to be accepted by the silenced. People meeting as caricatures of human beings, offering their silence to each other, their ability to avoid connection. Dams and seawalls built against the stories, which sometimes break through and flood the city. Rebecca Solnit, “A Short History of Silence,” in The Mother of All Questions (Chicago: Haymarket Books, 2017), p. 38. So much injustice is reproduced by silence not because people do not recognize injustice, but because they do recognize it. Sara Ahmed, Living a Feminist Life (Durham and London: Duke University Press, 2017).