Hansjörg Dilger

Sexuality, AIDS, and the lures of modernity: Reflexivity and morality among young people in rural Tanzania

An understanding of young peoples perceptions of AIDS and their sexuality is an essential precondition for the effective planning of AIDS campaigns in sub-Saharan Africa. In examining how young Luo men and women in Tanzania describe their sexual behavior, I show that cultural conceptions of sexuality, gender, and trust have an important impact on their actions. I also show that these conceptions have been rendered ambiguous by globalization, modernity, and by AIDS campaigns themselves. The values that are imparted to young people from family or peers often conflict with the preventive advice provided by both governmental and non-governmental organizations. However, by critically reflecting upon the ambiguities and inconsistencies in their lives, the young Luo have proven to be self-conscious actors and moral subjects who are actively involved in the process of social change. In the concluding section I suggest how elements of self-critique and self-reflection, as well as the often differing perspectives and dilemmas experienced by young men and women, can be taken into account in order to make future educational campaigns more effective.

Healing the wounds of modernity: Salvation, community and care in a neo-pentecostal church in Dar Es Salaam, Tanzania

The responses of Christian religions to HIV/AIDS in Africa have been described either with regard to the stigmatising attitudes of churches, or with reference to the charitable acts of Christian organisations in the context of the epidemic. Drawing on fieldwork in a Neo-Pentecostal church in urban Tanzania, this article shows that the Full Gospel Bible Fellowship Church in Dar es Salaam is becoming highly attractive to its followers because of the social, spiritual and economic perspectives that it offers, and particularly because of the networks of healing and support that it has established under the circumstances of urbanisation, structural reform programmes and the AIDS epidemic. The author argues for a stronger focus on practices of healing and community building in studies on Pentecostalism, which may shed light on the continuities as well as the ruptures that are produced by the rise of Neo-Pentecostalism in the context of globalisation, modernity and HIV/AIDS.

Global AIDS medicines in East African health institutions

In this introduction to the special issue, we follow the journey of global AIDS medicines into diverse health facilities in East Africa, which for decades have been subjected to neoliberal reform processes and increasing fragmentation. The introduction explores the multifaceted and multidirectional connections between global processes and their manifold articulations and experiences “on the ground.” We sketch how individuals, families, and communities dealt with HIV/AIDS-related illness and death before the scale-up of life-prolonging antiretroviral therapy programs, and describe the global policy processes that led to an influx of large volumes of donor support for AIDS treatment programs. We argue that global AIDS medicines have caused dramatic changes in institutional set-ups and care practices. The pharmaceutical medicines travel to the local health care settings with “baggage”: protocols and guidelines on who to treat and why, with strict guidelines on how to ensure adherence; and new notions of responsible and therapeutic citizens. This special issue elucidates the frictions, negotiations, and ambiguities that have shaped the incorporation of global AIDS medicines in local healthcare settings.

Religion and the formation of an urban educational market: transnational reform processes and social inequalities in Christian and Muslim schooling in Dar es Salaam, Tanzania

Over the last decade in Tanzania parents’ and students’ quest for a good school has been shaped by the growing presence of religiously motivated schools, especially in urban settings. This paper argues that the diverse social positioning and educational appeal of new Christian and Muslim schools in Dar es Salaam are intimately intertwined with the continued weakening of state education that has been taking place since the mid-1990s to early 2000s as the result of privatization and World Bank educational policies. It also shows that the growing stratification and commodification of the education sector is tightly knitted with histories of inequality and religious difference in colonial and postcolonial Tanzania, as well as with the establishment and diversification of ties between actors and institutions on the East African coast on the one hand, and with those in North America, Europe, Kuwait, and Saudi Arabia on the other. Finally, this paper demonstrates how macroeconomic and macrohistorical forces have become condensed in processes of subject formation and the widely varying production of religious spaces in an urban educational market. I argue that the resulting reinscription of religion in the public sphere must be understood not so much as an unintended side-effect of transnational reform processes, but more as part and parcel of multilayered histories of schooling and Christian-Muslim encounters in Tanzania that have also shaped the recent repositioning of the country’s education sector in the global and transnational context.

Politics of Religious Schooling: Christian and Muslim Engagements with Education in Africa

AbstractIn recent decades, religiously motivated schools have gained a new social and political presence and significance in many African countries. Although religious networks and organizations—Christian as well as Muslim—have played a central role in providing education in colonial and postcolonial settings, liberalization and privatization measures since the 1980s have opened up new opportunities for religious engagement at all educational levels. The contributions to this issue explore the implications of these recent transformations on Christian and Muslim investments in the educational domain. To do so, they examine these implications in view of reconfigurations of national and regional educational fields under the influence of colonial and postcolonial administrations. Furthermore, they address the multiple, often-contested meanings, practices, and institutional setups that have shaped and been constituted by, the field of ‘religious schooling’ in the context of both neoliberal reform measures and transnational religious renewal trends. Finally, they illustrate the need to adopt an increasingly comparative perspective in the analysis of religious education, and to understand how (internally differentiated) instances of Christian and Muslim education have developed historically in relation to each other.

Ethics, epistemology, and engagement: encountering values in medical anthropology.

Over the last two decades, debates on ethics and reflections on the researcher’s positionality and responsibility have been established firmly in general anthropology (Abu-Lughod 1991; Caplan 2000;...

HIV-serostatus disclosure in the context of free antiretroviral therapy and socio-economic dependency: experiences among women living with HIV in Tanzania.

The worldwide implementation of free antiretroviral therapy (ART) raised great hopes among policy makers and health organisations about the positive changes it would bring about in attitudes and behaviours towards HIV and AIDS, as well as for infected peoples lives. A change in illness perception was anticipated, leading to the hypothesis of a possible change in disclosure rates, patterns and the choice of significant others to inform. In the era of free treatment availability in the United Republic of Tanzania, we examined reasons for disclosure and non-disclosure among HIV-seropositive women enrolled on ART and their choice of significant others to inform. In so doing, we contribute to the necessary yet neglected debate about the social impact of ART on the lives of infected women. The study, for which an ethnographic cross-sectional pilot approach was chosen, was conducted at the Care and Treatment Center (CTC) at Bombo Regional Hospital (BRH) in Tanga city, Tanzania. Data presented here derive from participant observation, questionnaires and semi-structured interviews conducted with 59 HIV-seropositive women on ART. Interestingly, and despite treatment availability, the choice of significant others to inform, as well as reasons for disclosure and non-disclosure, mirror findings from previous studies conducted before the introduction of free ART. The main reason for non-disclosure was fear of discrimination. The hope for social, economic or health support was the main motivation for disclosure, followed by the need for a ‘clinic companion’ in order to receive ART, as requested by hospital staff. Nevertheless, healthcare staff were not unanimous in thinking that disclosure is always beneficial, thus the recommended extent of disclosure varied. ART and concomitant factors were raised as an entirely new and significant reason for disclosure by interviewees. Finally, findings confirm that despite ART, disclosure remains a highly stressful event for women.

Negotiating Professionalism, Economics and Moral Obligation: An Appeal for Ethnographic Approaches to African Medical Migration

This article provides a preliminary framework of useful methodologies and topics for future ethnographic research on medical migration from Africa to North America. We argue that medical professionals’ migrations must be understood in terms of their multiple struggles for meaning as they negotiate their professional and personal preferences in light of their desires to help rebuild ailing medical systems in their countries of origin. Our ethnographic interviews suggest that networks and family have been of critical importance to medical mobility, as well as providing a potential means of continued involvement in philanthropic investments in their countries of origin. Ultimately, we argue that economic perspectives on medical migration are insufficient, and leave out the complexities of balancing professionalism, personal goals and moral obligation to the country of origin.

Im/mobilities and dis/connectivities in medical globalisation: How global is Global Health?

ABSTRACT The interdisciplinary, politically contested field of Global Health has often been described as a consequence of, and response to, an intensification of the mobilities of, and connectivities between, people, pathogens, ideas, and infrastructure across national borders and large distances. However, such global mobilities and connectivities are not as omnidirectional and unpatterned as the rhetoric of many Global Health actors suggests. Instead, we argue that they are suffused by a plethora of institutional, national, and global political agendas, and substantially shaped by transnational and postcolonial power relations. Furthermore, the configurations that are typically subsumed under the category of Global Health represent only a minor part of the range of im/mobilities and dis/connectivities that are essential for understanding transformations of epidemiological patterns, health care infrastructures, and the responses to health-related challenges in a globalising world. In order to broaden such a limiting analytical perspective, we propose to expand the analytical focus in studying Global Health phenomena by paying close attention to the myriad ways in which particular im/mobilities and dis/connectivities constitute medicine and well-being in global and transnational settings. Pursuing a conceptual shift from studies of ‘Global Health’ to studying ‘medical globalization’ may carve out new analytical ground for such an endeavour.

Data management in anthropology: the next phase in ethics governance?

Recent demands for accountability in ‘data management’ by funding agencies, universities, international journals and other academic institutions have worried many anthropologists and ethnographers. While their demands for transparency and integrity in opening up data for scrutiny seem to enhance scientific integrity, such principles do not always consider the way the social relationships of research are properly maintained. As a springboard, the present Forum, triggered by such recent demands to account for the use of ‘data’, discusses the present state of anthropological research and academic ethics/integrity in a broader perspective. It specifically gives voice to our disciplinary concerns and leads to a principled statement that clarifies a particularly ethnographic position. This position is then discussed by several commentators who treat its viability and necessity against the background of wider developments in anthropology – sustaining the original insight that in ethnography, research materials have been co‐produced before they become commoditised into ‘data’. Finally, in moving beyond such a position, the Forum broadens the issue to the point where other methodologies and forms of ownership of research materials will also need consideration.