Saturday is For Funerals

Last week the students and I discussed Unity Dow and Max Essex's Saturday is For Funerals.  This was both a difficult and inspiring text to read all at the same time.   The book was sectioned off into chapters that combined the personal reflections of Dow with the medical expertise of Essex.

If nothing else the book did a great job of illuminating the human toll of HIV in Botswana.  We were able to see just how widespread the epidemic is.  Furthermore, the text did an excellent job of explaining the emotional, physical, and psychological toll of the disease on families, communities, and society.

Perhaps the text placed a little bit too much faith on biomedical explanations for disease.  I was disturbed that Dow and Essex seemed to dismiss local conceptualizations of the body, disease, debility.  It was as if local understandings of these issues were devalued to the primacy of western biomedical explanations of disease.  This to me is a problem and I cannot imagine how the society can successfully address the issue of HIV/AIDS if embedded into the discourse of prevention and treatment is a disdain for alternative views of the body, health, and disease that are clearly still quite salient in contemporary Botswana.

Toward that end, while the book praised the Botswana government's efforts to address the crisis of HIV in the society, I could not help but think that too much faith was being placed in Western biomedical science as the solution to what clearly are complex problems that extend beyond disease models developed by western science.  While it was clear that the provision of anti-retroviral medications and the government's forceful response to the crisis of HIV impacted the willingness of people to test and treat, it was also clear that this was not enough, hence the development of the opt-out idea with respect to HIV testing.

While it is assumed that Botswana is an unequivocal success story with respect to HIV, I would like to challenge the students to question and critique this representation of how Botswana has handled the epidemic.  Surely the government must be commended for its timely and vigilant response.  But I hope that developing a more comprehensive understanding of the body and disease that is culturally appropriate and sensitive (while not encouraging practices that increase risk) will be something implemented by the Botswana government.

As for the students, I was once again impressed with their ability to handle the material in  a sensitive and nuanced manner.  As a kid of the 1980s, I was also surprised by how many expressed that the book was in many ways one of their first opportunities to learn more about the mechanics of HIV disease.  This was shocking to me and it made me question how far HIV has fallen off the radar in the United States as far as education concerning the  disease both from a social and scientific perspective.  Certainly, the United States does not have the epidemic of sub-Saharan African countries, but it should be noted that the United States has one of the worst epidemics among wealthy industrialized nations.  Dr. Reid pointed out how who is infected with HIV/AIDS in the United States (that is the preponderance of those infected being black and poor) has much to do with how the U.S. addresses this crisis.  It is certainly something to think about as additional people are thrown into poverty and the U.S. continues its cycle of growing inequality.