BETWEEN BEDROOMS AND BALLOTS: THE POLITICS OF HIV'S ...

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UEM UNGASS UNFPA UNDP UNAIDS VCT VSO WLSA WB Xindiro Universidade Eduardo Mondlane (university in Maputo) United Nations General Assembly Special Session (on HIV/AIDS) United Nations Population Fund United Nations Development Programme Joint United Nations Programme on HIV/AIDS Voluntary Counseling and Testing Voluntary Service Overseas Women and Law in Southern Africa World Bank Literally: small toy; HIV association that works with Rensida 20
Abstract of Dissertation Presented to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy BETWEEN BEDROOMS AND BALLOTS: THE POLITICS OF HIV’S ‘ECONOMY OF INFECTION’ IN MOZAMBIQUE Chair: Goran Hyden Major: Political Science By Kenly Greer Fenio May 2009 Mozambique is simultaneously experiencing democracy and a rapidly growing HIV/AIDS rate and thus offers fertile ground to explore new civil society associations and activities, the vast scale-up of public health care administration, tensions between formal and informal institutions, and state-society-donor relationships that combine calls for accountability with a historical fear of the state. This research focuses on the linkages between HIV/AIDS, mobilization within civil society, and government policy, particularly in relation to their aggregated contribution to, and reciprocal relationship with, democracy. Through participant observation, in-depth interviews, focus groups and over 300 surveys, it documents activity occurring within the public realm by HIV-oriented and human rights-oriented volunteer associations in five key research sites throughout Mozambique. I argue that HIV volunteers are: 1. contesting the informal institutions found at the community level in the attempt to change patriarchal practices and inequality; 2. involved in the rapid scale up of decentralized public health services and the attempts to hold government accountable for assistance; and 3. learning civic skills used in other activities that may be defined as political. This research enhances current understanding of political activity in the public sphere and the political economy of HIV/AIDS, and contributes to prevalent 21
Page 1 and 2: BETWEEN BEDROOMS AND BALLOTS: THE P
Page 3 and 4: For my mother Mary Jo, the dancer;
Page 5 and 6: To the Mozambican crew: Julio Antó
Page 7 and 8: all out every Wednesday and remembe
Page 9 and 10: TABLE OF CONTENTS ACKNOWLEDGMENTS .
Page 11 and 12: Reasons for Inactivity.............
Page 13 and 14: LIST OF TABLES Table page 2-1 Healt
Page 15 and 16: 7-4 Perceptions of danger in vocali
Page 17 and 18: LIST OF ABBREVIATIONS ABC Ahitipalu
Page 19: NAC NACP NIE OHCHR OTM OMM PEPFAR P
Page 23 and 24: CHAPTER 1 INTRODUCTION Introduction
Page 25 and 26: poverty as a driving force behind c
Page 27 and 28: difficulties, yet possibilities, in
Page 29 and 30: institutions; participation, or lac
Page 31 and 32: many African countries, the percent
Page 33 and 34: civic-ness) to human rights mobiliz
Page 35 and 36: end of the war many still have diff
Page 37 and 38: chapters contributes in various cap
Page 39 and 40: with HIV. This occurrence would hav
Page 41 and 42: CHAPTER 2 THE REALITIES OF HIV/AIDS
Page 43 and 44: years, individuals have cited a fea
Page 45 and 46: Certain regions in Mozambique are w
Page 47 and 48: cooperatives, for schools/supplies,
Page 49 and 50: migrated to South African mines. In
Page 51 and 52: Education, created violence awarene
Page 53 and 54: Guebuza’s business interests (par
Page 55 and 56: The highest infection rates are fou
Page 57 and 58: Figure 2-4. Transportation routes i
Page 59 and 60: Since 1994, over 400 health centers
Page 61 and 62: By the end of 2002, 1000 HIV+ pregn
Page 63 and 64: public sector. Overall, however, a
Page 65 and 66: Sanitation, Food and Water Three-qu
Page 67 and 68: On paper, the new standards for hum
Page 69 and 70: and malaria, and in 2005 constitute
Page 71 and 72:
on existing services within the cou
Page 73 and 74:
Table 2-2. ARV distribution sites a
Page 75 and 76:
transforming subjects into citizens
Page 77 and 78:
and shame-inducing or, more broadly
Page 79 and 80:
difference between ‘rights in peo
Page 81 and 82:
of several ways to bring in adheren
Page 83 and 84:
emerged when individuals had varyin
Page 85 and 86:
divine right, then the exclusion of
Page 87 and 88:
ecause the realms often overlap, mu
Page 89 and 90:
…the ‘services’ one sought co
Page 91 and 92:
Contemporary State-Society Relation
Page 93 and 94:
associational life); (Harbeson, Rot
Page 95 and 96:
and organizations (particularly in
Page 97 and 98:
(Templeman 1999) Herbst (1990) also
Page 99 and 100:
voice in the means of state engagem
Page 101 and 102:
in two ways: by lobbying the state
Page 103 and 104:
feminist theorists that it must not
Page 105 and 106:
associations that have mobilized fo
Page 107 and 108:
domain. Specific research questions
Page 109 and 110:
Guiding this inquiry is the indepen
Page 111 and 112:
in Maputo and Boane (in the south o
Page 113 and 114:
that not all HIV mobilizers are HIV
Page 115 and 116:
Research Sites, Subjects and Assist
Page 117 and 118:
The population in the District of C
Page 119 and 120:
marked with an asterisk* in the fol
Page 121 and 122:
For surveys, I trained five researc
Page 123 and 124:
Finally, it needs to be highlighted
Page 125 and 126:
other half, either we didn’t have
Page 127 and 128:
Table 4-2. Continued Name of associ
Page 129 and 130:
Table 4-3. Hospital comparison Hosp
Page 131:
Some of the groundbreaking institut
Page 134 and 135:
While in Europe daughters received
Page 136 and 137:
and patriarchy now continues an une
Page 138 and 139:
significant obstacle to this was th
Page 140 and 141:
can function only with the cooperat
Page 142 and 143:
through individual, personal exchan
Page 144 and 145:
elations; (Bratton 1989) women who
Page 146 and 147:
depending on the dominant language
Page 148 and 149:
While some define traditional autho
Page 150 and 151:
efficiency and to regulate action.
Page 152 and 153:
Due to the disengagement from the s
Page 154 and 155:
individuals will be more comfortabl
Page 156 and 157:
were volunteers, but now they recei
Page 158 and 159:
egarding formalized women’s right
Page 160 and 161:
to signify a lack of interest on th
Page 162 and 163:
high, mainly because of food insecu
Page 164 and 165:
icycle taxis pull up to the first r
Page 166 and 167:
is his responsibility to resolve a
Page 168 and 169:
have sex with animals, like monkeys
Page 170 and 171:
come in from the land, he allows ph
Page 172 and 173:
higher percentage of women HIV mobi
Page 174 and 175:
without an in-depth knowledge of wh
Page 176 and 177:
anging from a lack of discussion to
Page 178 and 179:
the sporadic use of regulados, the
Page 180 and 181:
Table 5-3. Decisions about children
Page 182 and 183:
Table 5-9. Type of mobilizer and at
Page 184 and 185:
world when the civil war ended in 1
Page 186 and 187:
low life expectancy, they will exis
Page 188 and 189:
As we saw within some of the litera
Page 190 and 191:
the context of a relationship, wher
Page 192 and 193:
fear of community stigma over the d
Page 194 and 195:
The low pay of government positions
Page 196 and 197:
Often the régulos will organize cu
Page 198 and 199:
More importantly, however, an empha
Page 200 and 201:
each of the regions claimed to mobi
Page 202 and 203:
Reasons for Inactivity Non-mobilize
Page 204 and 205:
afraid to attend the hospital to re
Page 206 and 207:
As briefly mentioned in the last ch
Page 208 and 209:
still varying but lower (71%). 40 T
Page 210 and 211:
the only significance is that human
Page 212 and 213:
is difficult to establish, yet prev
Page 214 and 215:
Location is important here as most
Page 216 and 217:
than individual economic or job rel
Page 218 and 219:
Most view it as public (public topi
Page 220 and 221:
in the economy of affection to sust
Page 222 and 223:
Table 6-3. Financial incentive and
Page 224 and 225:
Table 6-7 Scale of ‘community inc
Page 226 and 227:
Table 6-11. Scale of Trust of commu
Page 228 and 229:
Table 6-18. Preference in discussio
Page 230 and 231:
Table 6-21. Scale of activities in
Page 232 and 233:
Table 6-27. HIV and human rights mo
Page 234 and 235:
understand the “publicity of repr
Page 236 and 237:
appeals to a sense of community, an
Page 238 and 239:
such was the intention of the actor
Page 240 and 241:
Additionally, advocacy also involve
Page 242 and 243:
its own coordinator but there is li
Page 244 and 245:
song praising Rensida: “We are ha
Page 246 and 247:
Father: Quiet my daughter because w
Page 248 and 249:
various areas of the offices; some
Page 250 and 251:
audience members take turns dancing
Page 252 and 253:
protests or marches, but in reality
Page 254 and 255:
Corruption in the Health Sector A F
Page 256 and 257:
Although AIDS drugs are free within
Page 258 and 259:
activists are less advocacy-oriente
Page 260 and 261:
December 2006) The roles of these o
Page 262 and 263:
as human rights mobilizers) perceiv
Page 264 and 265:
individuals simply see the AIDS dom
Page 266 and 267:
Macuta, 4 April, president of Kulup
Page 268 and 269:
in turn doesn’t say anything abou
Page 270 and 271:
ack. This man says he has one proje
Page 272 and 273:
others to support a candidate or po
Page 274 and 275:
government provision of health infr
Page 276 and 277:
mobilizers are more likely to have
Page 278 and 279:
education through information disse
Page 280 and 281:
count hits 250, which is somewhat s
Page 282 and 283:
Thus, we can reject the null hypoth
Page 284 and 285:
information transmission within Afr
Page 286 and 287:
Table 7-3. Perceptions of corruptio
Page 288 and 289:
Table 7-9. Scale of interest and di
Page 290 and 291:
Table 7-15. Scale of interest and d
Page 292 and 293:
Table 7-21. Influence II How much i
Page 294 and 295:
Table 7-24. Continued Before joinin
Page 296 and 297:
CHAPTER 8 MOVING FROM SUBJECTS TO C
Page 298 and 299:
partner’s status) and thus create
Page 300 and 301:
HIV/AIDS programs because of this i
Page 302 and 303:
or accessible employment), then lit
Page 304 and 305:
times a year), also include more im
Page 306 and 307:
are trying to overcome their oppres
Page 308 and 309:
Patriarchy Poverty Particular types
Page 310 and 311:
We might frame this as a way to beg
Page 312 and 313:
choose or are forced to spin off in
Page 314 and 315:
subsidies, hence the line is render
Page 316 and 317:
most resist such change, particular
Page 318 and 319:
Interdependence and regulation HIV
Page 320 and 321:
domestic relationships; and allowed
Page 322 and 323:
Of course, although such outside re
Page 324 and 325:
include keeping quiet about the dys
Page 326 and 327:
etween the private and public arena
Page 328 and 329:
APPENDIX A ASSOCIATION OVERVIEW Ove
Page 330 and 331:
Working mainly in Maputo (but tryin
Page 332 and 333:
Ahitipaluxeni: (Shangana for ‘vam
Page 334 and 335:
Maputo: human rights associations M
Page 336 and 337:
ased programs only go to HIV based
Page 338 and 339:
office. It receives no funding from
Page 340 and 341:
When a domestic problem becomes a s
Page 342 and 343:
egions of the country. It has organ
Page 344 and 345:
• feel they have little influence
Page 346 and 347:
(Education in association) No signi
Page 348 and 349:
H3: HIV mobilizers partake in more
Page 350 and 351:
Expectations of donors Expectations
Page 352 and 353:
After association volunteer with go
Page 354 and 355:
H8: HIV mobilizers are less likely
Page 356 and 357:
2005 New Constitution PLWHA qualify
Page 358 and 359:
We would like to ask you about how
Page 360 and 361:
Do you or your partner make most of
Page 362 and 363:
Who is responsible for providing: S
Page 364 and 365:
A For those in organization I found
Page 366 and 367:
Do you feel that vocalizing opposit
Page 368 and 369:
How strongly do you identify with o
Page 370 and 371:
(For non mobilizers) Questions pert
Page 373 and 374:
Pitakufa Pito Quadrado Regulado Ré
Page 375 and 376:
Barcellos, Némora Tregnago. 2005.M
Page 377 and 378:
Chabal, Patrick and Jean-Pascal Dal
Page 379 and 380:
Education Action 18. N.D. “Positi
Page 381 and 382:
Freedom House. 2008. Freedom in the
Page 383 and 384:
Helmke, Gretchen and Steven Levitsk
Page 385 and 386:
James, Wendy 1978. “Matrifocus on
Page 387 and 388:
Mosse, Marcelo. 2004. Corrupção e
Page 389 and 390:
Patterson, Amy. 2005. The African S
Page 391 and 392:
Simon, Herbert A. 1982. Models of B
Page 393 and 394:
UNAIDS. 2008b. “Epidemiological F
Page 395 and 396:
WHO (with UNAIDS and UNICEF). 2008.
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