Vandana Wadhwa

Vulnerability to HIV/AIDS among women of reproductive age in the slums of Delhi and Hyderabad, India

This report explores how vulnerability to HIV/AIDS applies to women in the reproductive age range living in the slum areas of Delhi and Hyderabad. The paper is based on a qualitative study of AIDS awareness levels conducted during the summer of 2006. It offers insightful narratives from a sample of 32 women, providing an in depth view of their vulnerability to HIV/AIDS due to their precarious socioeconomic conditions and low AIDS awareness. The women cited lack of education, low empowerment in expressing and accessing information related to sexual matters, and poverty as key factors to vulnerability.

Malaria Resurgence in Urban India: Lessons from Health Planning Strategies1,2

Urban malaria has become an important issue in the overall strategies in the control/eradication of malaria in India. This chapter highlights the fact that unplanned and haphazard developmental activities have resulted in deteriorating urban environments, which in turn have created conducive breeding areas for certain malaria vectors such as Anopheles stephensi. This chapter identifies urban regions where malaria surfaced as early as 1962–1963 and implicates construction activities, green belts, and poor water and drainage conditions in the slums as major factors responsible for the spread of malaria. API rates were used to compare malaria occurrence during 1978 and 1993, finding that the above development activities and population resistance to malaria are two of the important factors in variations in malaria patterns over time and space.

Structural Violence and Women's Vulnerability to HIV/AIDS in India: Understanding Through a “Grief Model” Framework

HIV/AIDS remains one of Indias major health concerns today, with 2.27 million people affected by the disease. Ineffective/inappropriate policy stances at the incipient stages of the epidemic are primarily to blame. The Indian governments slow progression through stages of denial and stalling to final acceptance for comprehensive action is analogous to the psychiatric model of dealing with grief. This qualitative study, based on in-depth interviews of key informants from urban health posts serving four slums in Delhi and Hyderabad cities, explores AIDS awareness and attitudes in the community and HIV/AIDS policy efficacy. Findings reveal (i) a largely reactive policy response creating a circular relationship between policy, prevalence, and awareness, where policies often create local patterns of HIV/AIDS occurrence and awareness, which then inform next steps; (ii) the existence of institutional and socioeconomic barriers (poverty, underdevelopment, lack of transparency, taboo, and stigma), which can be conceptually framed as “structural violence.” The article concludes that the governments “Grief Model” policy response is another frame of reference through which structural violence can be understood.

The Dynamics of Urban Malaria in India: An Update

This chapter highlights the ways in which urban malaria in India continued to be a source of great concern to the government, health planners, and related officials all the way into the early 1990s. It updates the scenarios described and analyzed in the previous chapter up to the year 1997, the latest year of the twentieth century for which urban malaria data were available to the authors. The previous chapter was founded upon a matrix of malaria and health planning history in India up to the year 1995; the present chapter updates the same but also uses the relationship between urban ecology and malaria occurrence as its foundation. It proposes cycles of malaria resistance and regional occurrence as explanatory mechanisms of spatio-temporal patterns of malaria occurrence.

Lessons from the past, view to the future: summary and concluding remarks.

South Asia is a cohesive region and yet diverse, both in terms of physical and socio-cultural environments. This concluding chapter summarizes these similarities and variations in the context of malaria occurrence and specifically highlights common challenges such as the ever-conducive climate and the threat of climate change, cultural practices, socio-economic constraints, and political disruptions. It updates the malaria situation in South Asia into the twenty-first century and discusses the successes and failures of new drugs like ACTs and the return to old mainstays like DDT. Also addressed are the changing directions of global programs, the value of regional and multi-sectoral approaches, and the promise held by technological and scientific advances. In the end, the best course of action for now seems to be the use of effective and sustained surveillance, prophylaxes, prevention, control, and cure measures.

Natural Resource-Based Livelihoods in the Context of Climate Change: Examining the Stance of Decision Makers in India

Climate change varies across different regions and leads to changes in many meteorological elements such as rainfall, temperature, sea level, and various extreme events. These changes not only affect natural and human systems independently but also their interfaces, thus changing ecosystems and production, diversity, and the functionalities of livelihoods. People engaging in primary economic activities such as farming, fishing, or forestry comprise a large proportion of the Indian population and are the most vulnerable to changes in weather patterns as they depend directly on these eco-resources for their livelihood. Therefore, it is highly essential to address the issue of climate change to ensure the steadiness of their sources of livelihood. The words of the decision makers thus become very important; any decisions regarding future development should take into account climate change and its impact on livelihoods, and correspondingly, the words of decision makers at the national and local level should reflect cognizance of this relationship. This chapter discusses the stance of the country’s decision makers regarding this relationship through the means of text-based pragmatic analysis that examines decision makers’ speeches and statements for their level of concern regarding the climate change–livelihood preservation relationship. It highlights the disparity between the people’s reality and the knowledge base of the experts, which are certainly available to these decision makers, and what really seems to concern the decision makers. The study finds that references to livelihood preservation are at best implicit when present, but are largely conspicuous by their absence in text.

Cartographies of disease: Maps, mapping, and medicine

are still some areas that might be unclear to those who are inexperienced in social research. Their stated goal was to provide an overview that clearly defines what projective techniques are and how to use them. The coverage of Thematic Appreciation Measures and other psychological tests throughout the book provides a very clear understanding of these techniques without merely reducing them to variations of the Rorschach test. Much less time is spent on the individual techniques of visual sociology. This book would be well suited for the classroom setting as a secondary reader to supplement the main text. It is unclear as to the connection social research has with business research, though it does beg the question of how we might more adequately use these techniques.

The History and Progression of Malaria: A Global and Regional View

Malaria remains one of the worst killers in the world today and is the cause of even greater suffering in human, social, and economic terms. This chapter seeks to introduce the reader to various facets of this age-old disease, including malaria disease ecology, the course of malaria occurrence and diffusion over the ages, and the various traditional and public health measures that have been used for protection, prevention, and cure. The chapter focuses specially on the twentieth century, when a better understanding of the disease and various scientific advancements led to its near eradication in many parts of the world, including South Asia. These advances included anti-malaria drugs, pesticides such as DDT, better public heath measures, and the quest for an effective vaccine. Meanwhile, not only has South Asia faced resurgence in malaria occurrence since the 1960s and 1970s, but global trends in malaria mortality and morbidity discussed in this chapter reveal that most tropical regions of the world have been unable to loosen malaria’s grip on them even today. An overview of what the rest of the book will discuss rounds out this introductory chapter.