Local Biologies, and ART Protocols: A Political Ecology of Tuberculosis and the Body

Speaker: Abby Neely
Date: Friday 24 May 2013
Time: 12:30-14:00
Venue: CCS Seminar Room, 602, 6th Floor, MTB Tower, Howard College

Topic:
South Africa is known for its high rates of HIV and tuberculosis, where the HIV pandemic has provided fertile ground for a wave of TB infection.  Indeed, HIV-TB coinfection is widely understood as one of, if not, the biggest health problems in the country. In practice, doctors and nurses understand that any unusual case of tuberculosis is an indication of HIV and they make diagnoses and treatment plans accordingly. This understanding is informed by population-scale data with little attention to individual people and the political-economic, cultural, social, and environmental contexts in which they live.  Political-ecology, with its place-based analysis and with its utilization of quantitative, scientific data alongside ethnography provides an excellent framework for understanding South Africa’s HIV and TB in the context of poverty and local understandings of ill health.  For a political ecology framework to be useful, however, we must expand our understanding of ecology by looking at the body as having its own, internal ecology.  By combining this “ecological” framework with health geography’s and medical anthropology’s insights into the embodied experience of illness in its cultural, social, and political-economic context, a political ecology of health emerges.  This paper begins with an ethnographic story of the diagnosis of a woman infected with milliary TB but not HIV to show the importance of what Becky Mansfield and Julie Guthman have called, a “political ecology of the body.”  By examining the science of miliary tuberculosis alongside population-scale understandings of HIV-TB coinfection in the specific context of rural, South Africa, this paper challenges the way we understand the health impacts of the HIV/AIDS epidemic by suggesting that the epidemic has health negative implications far beyond those people who are HIV positive.

Speaker:
Abigail Neely is an Assistant Professor (Lecturer) in the Department of Geography, Environment and Society at the University of Minnesota.  She is a political ecologist who conducts research in Pholela (Bulwer) and is presently completing a book manuscript entitled, Women and Bureaucrats, Witchcraft and Nutrients: Health and Nature in Twentieth Century South Africa about the evolution of the relationships between health and environment and shifts in understandings about those relationships from the 1930s to the 1980s.  Focused at the site of the Pholela Community Health Centre, this book looks at how practice and ideas change at the interface of social medicine, the implementation of Betterment, and long-standing local practices and understandings.
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