The Unseen Things

Kathryn A. Rhine

Description

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What do HIV-positive women in Nigeria face as they seek meaningful lives with a deeply discrediting disease? Kathryn A. Rhine uncovers the skillful ways women defuse concerns about their wellbeing and the ability to maintain their households. Rhine shows how this ethic of concealment involves masking their diagnosis, unfaithful husbands, and unsupportive families while displaying their beauty, generosity, and vitality. As Rhine observes, collusion with counselors and support group leaders to deflect stigma, secure respectability, and find love features prominently in the lives of ordinary women who hope for a brighter future as the HIV epidemic continues to expand.

Introduction: Things Unseen
1. First Loves
2. Twice Married
3. Dilemmas of Disclosure
4. Intimate Ethics
5. Hope
Conclusion: Evidence and Substance
Notes
Bibliography
Index

Sujets

• Santé et bien-être
• Santé du quotidien
• Santé au quotidien
• Santé au quotidien
• HIV
• Nigeria
• Fitness
• Health
• Anthropology
• Women's health
• Northern Nigeria
• VIH
• Women's Health
• African Studies

Informations

• Publié par: Indiana University Press
• Date de parution: 04 avril 2016
• Nombre de lectures: 0
• EAN13: 9780253021519
• Langue: English

Extrait

THE UNSEEN THINGS
THE UNSEEN THINGS
WOMEN, SECRECY,
and
HIV IN NORTHERN NIGERIA

KATHRYN A. RHINE
INDIANA UNIVERSITY PRESS
Bloomington Indianapolis
This book is a publication of
Indiana University Press
Office of Scholarly Publishing
Herman B Wells Library 350
1320 East 10th Street
Bloomington, Indiana 47405 USA
iupress.indiana.edu
2016 by Kathryn A. Rhine
All rights reserved
No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher. The Association of American University Presses Resolution on Permissions constitutes the only exception to this prohibition.
The paper used in this publication meets the minimum requirements of the American National Standard for Information Sciences-Permanence of Paper for Printed Library Materials, ANSI Z39.48-1992.
Manufactured in the United States of America
Library of Congress Cataloging-in-Publication Data
Names: Rhine, Kathryn, author.
Title: The unseen things : women, secrecy,
and HIV in northern Nigeria / Kathryn A. Rhine.
Description: Bloomington : Indiana University Press, 2016. | Includes bibliographical references and index.
Identifiers: LCCN 2016001266| ISBN 9780253021311 (cloth : alk. paper) | ISBN 9780253021434 (pbk. : alk. paper) | ISBN 9780253021519 (ebook)
Subjects: LCSH: HIV-positive women-Nigeria-Social conditions. | HIV-positive women-Behavior-Nigeria. | HIV-positive women-Nigeria-Attitudes. AIDS (Disease) in women-Nigeria. | Secrecy.
Classification: LCC RC607.A26 R458 2016 | DDC 362.19697/92009669-dc23
LC record available at http://lccn.loc.gov/2016001266
1 2 3 4 5 21 20 19 18 17 16
This book is dedicated to Grace, Victoria, and Hauwa .
CONTENTS
Acknowledgments
Introduction: Things Unseen
1. First Loves
2. Twice Married
3. Dilemmas of Disclosure
4. Intimate Ethics
5. Hope
Conclusion: Evidence and Substance
Notes
Bibliography
Index
ACKNOWLEDGMENTS
THE UNSEEN THINGS first began as a research proposal I wrote as an undergraduate nearly 15 years ago. I have thus accumulated so many debts to people and institutions that it is nearly impossible to recognize them all here. Moreover, in a book about secrecy and the dignity people seek through privacy, public acknowledgements to those who have contributed the most are difficult. I am grateful to many individuals - some of whom I cannot name. The women you read about in this text, and so many more, have generously taken me into their homes and lives, devoting long hours to teaching me about their society and sharing deeply personal stories. I have been fortunate to have their companionship, patience, and trust throughout this challenging project.
My motivation for this research first came from an inspiring group of individuals at a camp for families affected by HIV in the United States. I am particularly grateful for the introduction that Lauren Wood gave me to her colleague, Samuel Adeniyi-Jones at the National Institutes of Health, who convinced me that Nigeria was an important place to learn more about antiretroviral therapies and the prevention of mother-to-child transmission of HIV . He, in turn, introduced me to Alash le Abimaku at the Institute for Human Virology, who enthusiastically supported my plans for a year of research in Jos, Nigeria. With the support of the George Washington University Honors program, and my anthropology advisor Barbara Miller, I applied for and received a William J. Fulbright Fellowship (IIE) to Nigeria and a Boren Fellowship for Hausa language study to carry out this work.
I first began my project in 2002 among a great team of clinicians and researchers at the Plateau State Specialist Hospital, including Comfort Daniyam and Edwina Mang. I am leaving out the name of the second clinic within which I worked in order to protect the confidentiality of some of the women in this text; however, I would like to thank Chris and Mercy, the clinic staff and volunteers, and the men and women in the support group for the kindness and generosity they extended to me. Laura (Mullen) Dobson was my closest academic friend during this period. I would never have made it through my first year without her. I also had the support of the Public Affairs Section at the US Embassy in Abuja. I thank Atim George, James Moolom, and Dehab Ghebreab, as well as their colleagues at PAS for their continued assistance and encouragement.
Once I began my graduate studies in 2003, I left Jos to explore the topics of HIV , women, and family life in the northern Nigerian city of Kano. In 2004, I was fortunate to meet Halima Ben Umar at a conference, and she invited me to spend the summer with her family. There, I benefited tremendously from her network of public health colleagues, who connected me with the support group I worked with that year. While in Kano, Khadijah Ibrahim Nuhu shared her intellectual gifts and passionate spirit with me, as my research assistant, key informant, and best friend. Her unwavering support, and insight were instrumental to my findings and overall well-being in Kano. Her husband Yaro and his wonderful family opened up their house to me and provided the emotional and practical support I needed. I have fond memories of spending time with Yaro s mother, Habiba and Bala, Maryam and Umar, Sadique and Ummi, their children, and other relatives. I equally enjoyed spending time with Khadijah s two sisters, Zainab and Rashida. I did not know it then, but Rashida would eventually make the most impact on my study, as my research assistant between 2006 and 2010. Like her sister, Rashida is fiercely smart and funny. She is a tireless, kind, and sympathetic researcher, who carefully listens and critically reflects on what she learns without reactionary judgment - a natural anthropologist.
In 2005, I spent time in both Jos and Kano to narrow my research focus. I had the great privilege of working with Kate (Bowler) Sabot while she conducted her MPH fieldwork on HIV -positive women s reproductive intentions. I also met Bola Gobir, Abdulatif Salisu, and Muyi Aina, and so many others who were charged with rolling out PEPFAR in those first few years. I am inspired by their hard work and sense of humor through it all.
The majority of the fieldwork, upon which this book is based, was conducted between 2006 and 2008 and was funded by the National Science Foundation and the US Department of Education. Over this period, with subsidized HIV testing and treatment programs underway, I worked closely with a faith-based hospital in Kano, which provides antiretroviral therapies and clinical care to over a thousand HIV -positive men, women, and children. I would like to thank Mudassar and his outstanding staff. The clinic generously provided me the space to conduct interviews with women from their support group. Although I cannot name everyone, I am grateful for the knowledge I gained from them.
At this hospital, there is one particular Treatment Support Specialist (I called her Patience in the book) who was instrumental in locating women for me to interview. I followed her in her day-to-day work, learning everything she could teach me about the marital and reproductive dilemmas faced by HIV -positive women. In addition, I often stayed in her house, ate her delicious cooking, and traveled with her to visit other patients and family in different cities across northern Nigeria. Patience is a true friend. This book would never have emerged without her.
During these years, I also conducted a survey and completed interviews with over a hundred HIV -positive women in two hospitals, as well as three additional support groups. There were numerous non-governmental organizations across Kano and Abuja, who also opened their doors to me. Dr. Yusuf Adamu helped facilitate an affiliation with the Department of Geography at Bayero University Kano, and introduced me to colleagues at the university including one of my hosts, Dr. Koguna, with whom I stayed in the old city of Chedi. In 2006, I met the Ammouri family, who quickly became some of my closest friends. I am so lucky to know Jalal, Nada, Mohamad, Maryam, Manal, and of course, Durba, who keep me thoroughly entertained and well-fed every time I travel to Nigeria.
During particularly stressful periods of fieldwork, I was fortunate to be able to fall back on my long-time friends Brent and Eugenie Friedrichs in Jos, who have so much love for the country - and always had a chair open for me on their patio at 4 PM for a Star beer and peanuts. I also spent a month with Laura Arntson in Abuja, where we also became fast friends. Laura continually reminds me of the applied significance of this project and is a staunch advocate for the field of anthropology in the public health arena. I am grateful for the opportunities that USAID and the US Embassy in Abuja gave me to present my work to them.
I am indebted to Daniel J. Smith, my advisor in the Department of Anthropology at Brown University, along with the members of my committee, Marida Hollos, Pat Symonds, and Kris Peterson, my outside reader, for their careful reading and feedback. Dan s generous and committed attention, in particular, helped advance my scholarship in numerous critical dimensions. I was very fortunate to receive advice and feedback over the years from a number of other faculty members, including: Nick Townsend, Lina Fruzzetti, Phil Leis, Kay Warren, Cathy Lutz, and David Kertzer. The Population Studies Training Center also provided me substantial support. I am especially grateful for the assistance Kelley Smith gave me.
My final year at Brown, the Cogut Center for the Humanities offered me a congenial environment for reflection and writing. A wonderful group of faculty and graduate student fellows including Sarah Moran and Sarah Wald also helped me see this project to its concl