It's never as easy as ABC: Understandings of AIDS in Botswana1

Abstract

This paper argues for the importance of examining the way the messages of Government AIDS educational campaigns in Africa are interpreted at the local level. One of the striking features of the HIV/AIDS epidemic in Botswana is that it is not universally seen as a ‘new’ disease syndrome but as an ‘old’ one. HIV/AIDS has been interpreted by traditional healers as a manifestation of old ‘Tswana’ diseases, acquiring new virulence because of the increasing disrespect for the mores of traditional culture, or as a result of ‘old’ diseases mutating as they have ‘mixed together’. This alternative discourse of AIDS is set first in the context of official Health Education programmes and policy. It is argued that the fact that these programmes and policies have been couched exclusively in biomedical terms, and in apparent ignorance of other conceptualisations, has been detrimental to public education and understanding. Further, it has encouraged the development of a powerful and coherent counter discourse, based in the common understandings of Tswana society and cosmology. The main concern of this paper is to contextualise this counter discourse in order to understand why there has been a move to ‘claim’ the disease, turning it thus from a global problem into a local one. It is argued that it allows not only for a trenchant critique of current morality but also of the Government and the west. In turn, this raises a more general policy dilemma with regard to the dissemination of medical information in societies with plural health care systems, each operating on the basis of different truth claims. Where, as in southern Africa, these coincide with entrenched social divisions, educational interventions carry an inevitable political load, operating to locate the Government and its spokespeople on one or other side of the social (and epistemological) divide.