6 - Mother's Milk, An Ambiguous Blessing in the Bra of AIDS: The Case of'the Chagga in Kilimanjaro
Corresponding Author(s) : Karen Marie Moland
African Sociological Review,
Vol. 8 No. 1 (2004): African Sociological Review
Abstract
HIVIAIDS has renewed the need for a critical interpretation of hreastfeeding in social and cultural terms. The issue that this study addresses is how medically informed knowledge o_f HIV transmission through breastfeeding is interpreted and transformed in a local rural community in Kilimaryaro Region in northern Tanzania. The paper explores the articulation between a medical discourse on risk and a local dis course on motherhood which infrJrms the choice of infant jèeding method. Jt dis eusses the complexities involved in making an appropriate decision on breasiféeding, and argues that breas(feeding must be understood as close/y tied to the cultural elaboration of the female body and of motherhood. lt shows that the body of the mother and the body ()/'the newborn child are subject to close scrutiny and local diagnostic processes. Not breasifèeding is not only perceived as a significant fàilure of motherhood, but also rais es suspicion of a likely HIV positive status on the part of the mother.
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- Bond, V., Chase, and Aggleton, P. 2002. 'Stigma, HIV/AlDS and Prevention of Mother-to-Child Transmission in Zambia', Evaluation and Programme Planning, vol. 25, pp. 347-356.
- Baumslag, N., and Michels D.L. 1995. Milk, Money and Madness. The Culture and Politîcs ofBreastjèeding, London, Bergin and Garvey. Chopra, M., Piwoz, Scngwana, J., Schaay, N., Dunnctt, I., and Sanders, D. 2002. 'Effoct of a Mother-to-Child HIV Prevention Programme on Infant Feeding and Caring Practices in South Africa', South /????frican Medical .Journal, Vol. 92, pp. 298-302.
- Davis-Floyd, R.E., and Sargent, C.F. (eds.) 1997. Childbirth andAuthoritative Knowledge: Cross-Cultural Perspectives, London, University ofCalifornia Press.
- Handwerker, W.P. (cd.) 1990. Birth and Power: Social Change and the Politics of Reproduction, Boulder, W estview Press.
- Haram, L. 1999. "'Women out ofSight": Modem Women in Gendered Worlds. The Case of the Meru ofNorthem Tanzania', Unpublished Doctoral Dissertation, University of Bergen.
- Howard, M., and Millard, A. 1997. Hunger and Shame: Poverty and Malnutrition on Mount Kilimanjaro, New York and London, Routledge.
- Illich, I. 197 6. Medical Nemesis: The Expropriation ofHealth, New York, Pantheon. Jordan, B. 1993. Birth in Four Cultures: A Crosscultural investigation ofChildbirth in Yucatan, Ho/land, Sweden, and the United States, Prospect Heights, Waveland Press. First published in l 978. Khatib-Chahidi, J. 1992.
- 'Milk Kinship in Shi'ite Islamie Iran', in Maher, V., The Anthropology of Breasifeeding: Maturai Law or Social Construct, Oxford, Berg Publishers Ltd. Klepp, K.I., Biswalo, P.M., Talle, A. (eds.), 1995. Young People at Risk: Fighting AJDS in Northern Tanzania, Oslo, Scandinavian University Press.
- Lie, G.T. 1996. The Disease That Dares Not Speak lts Name: Studies on Factors of Importance.
- for Coping with HIV/ AIDS in Northern Tanzania, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen. Lindenbaum, S., and Lock, M. (eds.) 1993.
- Knowledge, Power and Practice: The Anthropology of Medicine and Everyday Life, Berkeley, University of Califomia Press.
- Lock, M. 2001. 'The Tempering ofMedical Anthropology: Troubling Natural Categories', Medical Anthropology Quarter/y, vol 15, no. 4, pp. 478-492.
- Lock, M., and Kaufcrt, P.A. (eds.) 1998. Pragmatic Women and Body Politics, London, Cambridge University Press.
- Maher, V. ( cd.) 1992. The Anthropology of Breasifeeding: Natural Law or Social Construct, Oxford, Berg Publishers Ltd.
- Martin, E. 1989. nie Woman in the Body: A Cultural Analysis of Reproduction, Boston, Beacon Press.
- Ministry ofHealth. 1997. Health StatisticsAbstract 1997, Dar es Salaam, Health Information, Research and Statistics Section, Planning Department, Ministry ofHealth.
- Ministry of Health. 1999. National AIDS Contrat Programme --- HIV/ AID51/S1D Surveillance, Report No. 14, December 1999, Epidemiological Unit, NACP.
- Ministry ofHealth. 2000. National AlDS Control Programme - HIVIAIDS'/STD Surveillance, Report No. 15, January-December 2000, Epidemiological Unit, NACP.
- Ministry ofHealth. 2003. Draft PMTCT National Guidelines, Unpublished.
- Mo land, K.M. 2002. 'Giving Birth in Kilimanjaro: The Politics ofKnowledge in Moral Contexts', Doctoral Dissertation, University of Bergen.
- Moore, S.F. l 986. Social Facts and Fabrications: 'Customa,y' Law on Kilimanjaro 1880-1980, Cambridge, Cambridge University Press.
- Moore, S.F. and Puritt, P. 1977. The Chagga and the Meru ofTanzania, London, International African fnstitute.
- de Paoli, M., et al. 2002. 'Counsellors Perspectives on Antenatal HIV Testing and enfant Feeding Dilemmas Facing Women with HIV in Northern Tanzania', Reproductive Health Matters, vol. 10, no. 20, pp. 144-156. Raum, O.F. 1996.
- Chaga Childhood: A Description <,iflndigenous Education in an EastAfrican Trihe, Hamburg, LIT Verlag. Published 1940 by the Oxford University Press. Setel, P. 1999.
- A Plague a/Paradoxes: AIDS, Culture and Demography in Northern Tunzania, Chicago, The University of Chicago Press.
- Salmon, M. 1994. 'The Cultural Significance ofBreastfeeding and Infant Care in Early Modern England and America', Journal qf Social History, vol 28, no. 2, pp. 247-269.
- UNAIDS. 1998. Report on the Global HIV/A/OS Epi.demie, Geneva, UNAIDS.
- UNAIDS/WHO/UNICEF. 1998. HIV and Infant Feeding: Guidelines for Decision--Makers, Geneva, UNAIDS.
- UNAIDS/UNICEF/WHO. 2002. Epidemiological Pact Sheets on HIV/ AIDS and Sexually Transrnitted Infections, United Republic ofTanzania.
- WHO. 200 L Prevention of Mother ta Child Transmission of HIV: Selection and Use of Nevirapine. Technical Notes, Geneva, World Health Organisation.
- Whyte, S.R. 1997. Questioning Misfortune: The Pragmatics q/Uncertainty in Eastern Uganda, Cambridge, Cambridge University Press
References
Bond, V., Chase, and Aggleton, P. 2002. 'Stigma, HIV/AlDS and Prevention of Mother-to-Child Transmission in Zambia', Evaluation and Programme Planning, vol. 25, pp. 347-356.
Baumslag, N., and Michels D.L. 1995. Milk, Money and Madness. The Culture and Politîcs ofBreastjèeding, London, Bergin and Garvey. Chopra, M., Piwoz, Scngwana, J., Schaay, N., Dunnctt, I., and Sanders, D. 2002. 'Effoct of a Mother-to-Child HIV Prevention Programme on Infant Feeding and Caring Practices in South Africa', South /????frican Medical .Journal, Vol. 92, pp. 298-302.
Davis-Floyd, R.E., and Sargent, C.F. (eds.) 1997. Childbirth andAuthoritative Knowledge: Cross-Cultural Perspectives, London, University ofCalifornia Press.
Handwerker, W.P. (cd.) 1990. Birth and Power: Social Change and the Politics of Reproduction, Boulder, W estview Press.
Haram, L. 1999. "'Women out ofSight": Modem Women in Gendered Worlds. The Case of the Meru ofNorthem Tanzania', Unpublished Doctoral Dissertation, University of Bergen.
Howard, M., and Millard, A. 1997. Hunger and Shame: Poverty and Malnutrition on Mount Kilimanjaro, New York and London, Routledge.
Illich, I. 197 6. Medical Nemesis: The Expropriation ofHealth, New York, Pantheon. Jordan, B. 1993. Birth in Four Cultures: A Crosscultural investigation ofChildbirth in Yucatan, Ho/land, Sweden, and the United States, Prospect Heights, Waveland Press. First published in l 978. Khatib-Chahidi, J. 1992.
'Milk Kinship in Shi'ite Islamie Iran', in Maher, V., The Anthropology of Breasifeeding: Maturai Law or Social Construct, Oxford, Berg Publishers Ltd. Klepp, K.I., Biswalo, P.M., Talle, A. (eds.), 1995. Young People at Risk: Fighting AJDS in Northern Tanzania, Oslo, Scandinavian University Press.
Lie, G.T. 1996. The Disease That Dares Not Speak lts Name: Studies on Factors of Importance.
for Coping with HIV/ AIDS in Northern Tanzania, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen. Lindenbaum, S., and Lock, M. (eds.) 1993.
Knowledge, Power and Practice: The Anthropology of Medicine and Everyday Life, Berkeley, University of Califomia Press.
Lock, M. 2001. 'The Tempering ofMedical Anthropology: Troubling Natural Categories', Medical Anthropology Quarter/y, vol 15, no. 4, pp. 478-492.
Lock, M., and Kaufcrt, P.A. (eds.) 1998. Pragmatic Women and Body Politics, London, Cambridge University Press.
Maher, V. ( cd.) 1992. The Anthropology of Breasifeeding: Natural Law or Social Construct, Oxford, Berg Publishers Ltd.
Martin, E. 1989. nie Woman in the Body: A Cultural Analysis of Reproduction, Boston, Beacon Press.
Ministry ofHealth. 1997. Health StatisticsAbstract 1997, Dar es Salaam, Health Information, Research and Statistics Section, Planning Department, Ministry ofHealth.
Ministry of Health. 1999. National AIDS Contrat Programme --- HIV/ AID51/S1D Surveillance, Report No. 14, December 1999, Epidemiological Unit, NACP.
Ministry ofHealth. 2000. National AlDS Control Programme - HIVIAIDS'/STD Surveillance, Report No. 15, January-December 2000, Epidemiological Unit, NACP.
Ministry ofHealth. 2003. Draft PMTCT National Guidelines, Unpublished.
Mo land, K.M. 2002. 'Giving Birth in Kilimanjaro: The Politics ofKnowledge in Moral Contexts', Doctoral Dissertation, University of Bergen.
Moore, S.F. l 986. Social Facts and Fabrications: 'Customa,y' Law on Kilimanjaro 1880-1980, Cambridge, Cambridge University Press.
Moore, S.F. and Puritt, P. 1977. The Chagga and the Meru ofTanzania, London, International African fnstitute.
de Paoli, M., et al. 2002. 'Counsellors Perspectives on Antenatal HIV Testing and enfant Feeding Dilemmas Facing Women with HIV in Northern Tanzania', Reproductive Health Matters, vol. 10, no. 20, pp. 144-156. Raum, O.F. 1996.
Chaga Childhood: A Description <,iflndigenous Education in an EastAfrican Trihe, Hamburg, LIT Verlag. Published 1940 by the Oxford University Press. Setel, P. 1999.
A Plague a/Paradoxes: AIDS, Culture and Demography in Northern Tunzania, Chicago, The University of Chicago Press.
Salmon, M. 1994. 'The Cultural Significance ofBreastfeeding and Infant Care in Early Modern England and America', Journal qf Social History, vol 28, no. 2, pp. 247-269.
UNAIDS. 1998. Report on the Global HIV/A/OS Epi.demie, Geneva, UNAIDS.
UNAIDS/WHO/UNICEF. 1998. HIV and Infant Feeding: Guidelines for Decision--Makers, Geneva, UNAIDS.
UNAIDS/UNICEF/WHO. 2002. Epidemiological Pact Sheets on HIV/ AIDS and Sexually Transrnitted Infections, United Republic ofTanzania.
WHO. 200 L Prevention of Mother ta Child Transmission of HIV: Selection and Use of Nevirapine. Technical Notes, Geneva, World Health Organisation.
Whyte, S.R. 1997. Questioning Misfortune: The Pragmatics q/Uncertainty in Eastern Uganda, Cambridge, Cambridge University Press