The Republic of Therapy: Triage and Sovereignty in West Africa's Time of AIDS

The Republic of Therapy: Triage and Sovereignty in West Africa's Time of AIDS

Paperback Body, Commodity, Text: Studies of Objectifying Practice

By (author) Vinh-Kim Nguyen

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  • Publisher: Duke University Press
  • Format: Paperback | 248 pages
  • Dimensions: 152mm x 231mm x 18mm | 363g
  • Publication date: 22 December 2010
  • Publication City/Country: North Carolina
  • ISBN 10: 0822348748
  • ISBN 13: 9780822348740
  • Edition: 1
  • Illustrations note: black & white tables
  • Sales rank: 285,893

Product description

The Republic of Therapy tells the story of the global response to the HIV epidemic from the perspective of community organizers, activists, and people living with HIV in West Africa. Drawing on his experiences as a physician and anthropologist in Burkina Faso and Cote-d'Ivoire, Vinh-Kim Nguyen focuses on the period between 1994, when effective antiretroviral treatments for HIV were discovered, and 2000, when the global health community acknowledged a right to treatment, making the drugs more available. He describes how in the intervening years, when antiretrovirals were scarce in Africa, triage decisions were made determining who would receive lifesaving treatment. He explains too how those decisions altered social relations in West Africa. In 1994, anxious to "break the silence" and "put a face to the epidemic," international agencies unwittingly created a market in which stories about being HIV positive could be bartered for access to limited medical resources. Being able to talk about oneself became a matter of life or death. Tracing the cultural and political logic of triage back to colonial classification systems, Nguyen shows how it persists in contemporary attempts to design, fund, and implement mass treatment programs in the developing world. He argues that as an enactment of decisions about who may live, triage constitutes a partial, mobile form of sovereignty: what might be called therapeutic sovereignty.

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Author information

Vinh-Kim Nguyen is Associate Professor of Social and Preventive Medicine in the School of Public Health at the University of Montreal.

Review quote

"In Republic of Therapy, the experts range from the international AIDS industry to Ivorian healers, activists, and friends of the author. Nguyen, a medical doctor and anthropologist, writes from his work as a community organizer among HIV-positive groups in West Africa, as an AIDS physician in an Abidjan clinic, and as an ethnographer in the city's subcultures... The book is important for understanding how 'technologies of the self' used by people in local organizations resemble both colonial patterns of interaction and international AIDS organizations' confessional theatre. AIDS treatment technologies make for a particular kind of politics." - Lisa Ann Richey, African Affairs "A tour de force. A Republic of Therapy is a shrewdly theorized ethnography of AIDS practices, technologies, drugs, confessions, and individuals in West Africa. Tracing how triage, confession, and activism emerged from 1995 in Abidjan, site of one of the very first HIV treatment programs in Africa, Vinh-Kim Nguyen analyses the workings and unintended consequences of a new politics of biomedical survival. Scrupulously un-romanticized, the book reveals francophone West Africans competing to stay alive in the time of AIDS, while actively linking their selves and bodies to practices of triage and confession. This sharp, urgent, and intellectually daring book brings uncommon critical insight to the violence of humanistic global health interventions and the searing paradoxes of triage."--Nancy Rose Hunt, author of A Colonial Lexicon: Of Birth Ritual, Medicalization, and Mobility in the Congo "The activist, physician, and anthropologist Vinh-Kim Nguyen has written an engaged, rigorous, and compelling account of the years when, in West Africa, AIDS treatment started to become available and persons living with HIV began to organize. With insight and sympathy, he explores how new political forms were thus invented in Cote d'Ivoire and Burkina Faso, combining therapeutic sovereignty and health democracy, triage of patients and empowerment of communities, confessions and accusations."--Didier Fassin, author of When Bodies Remember: Experiences and Politics of AIDS in South Africa

Back cover copy

"The activist, physician, and anthropologist Vinh-Kim Nguyen has written an engaged, rigorous, and compelling account of the years when, in West Africa, AIDS treatment started to become available and persons living with HIV began to organize. With insight and sympathy, he explores how new political forms were thus invented in Cote d'Ivoire and Burkina Faso, combining therapeutic sovereignty and health democracy, triage of patients and empowerment of communities, confessions and accusations."--Didier Fassin, author of "When Bodies Remember: Experiences and Politics of AIDS in South Africa"

Table of contents

Acknowledgments Introduction: Cote-d'Ivoire and Triage in the Time of AIDS; 1. Testimonials That Bind: Organizing Communities with HIV; 2. Confessional Technologies: Conjuring the Self; 3. Soldiers of God: Together and Apart; 4. Life Itself: Triage and Therapeutic Citizenship; 5. Biopower: Fevers, Tribes, and Bulldozers; 6. The Crisis: Economies, Warriors, and the Erosion of Sovereignty; 7. Uses and Pleasures: The Republic Inside Out; Conclusion: Who Lives? Who Dies? Notes; References; Index