Ensnared by AIDS: Cultural Contexts of HIV/AIDS in Nepal

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The way people make sense of illness is, in part, culturally determined. Existing beliefs and presuppositions shared by a community (cultural knowledge) regarding illness play a significant role in shaping an understanding of newly emerging illnesses in any given culture. This cultural knowledge is organized as cultural models, which are utilized to "make meaning of new situations such as the HIV/AIDS epidemic. These cultural constructions (cultural models) of illness can also contribute to the spread of the epidemic. Ensnared By Aids: The Cultural Contexts of HIV/AIDS in Nepal examines the meaning and cultural contexts of HIV/AIDS in Nepal where AIDS is a relatively new and rapidly growing problem. Until now little had been known about how Nepalis understand the illness locally known only as AIDS rog. This book presents the results of a long term study that examines the process by which the development of Nepalese cultural models of HIV/AIDS is occurring. It also introduces various illness schemata that underlic and inform these cultural models.

This book is based on the findings of two distinct studies conducted over a sixteen-month period in two locations of Nepal. The first study, employing traditional ethnoscience methods. explores illness beliefs and practices in rural Gorkha District of central Nepal. The findings suggest an emerging cultural model of HIV/AIDS that is based on an integration of 1) indigenous concepts (placing HIV/AIDS into a existing illness classification paradigm). 2) Western-based HIV/AIDS prevention education messages, and 3) public discourses of HIV/AIDS. The second study, based on the linguistic analysis of thirty texts collected from persons with AIDS (PWAs) living in the capital city of Kathmandu, illuminates emotional and contextual aspects of the contested cultural models. It also discriminates between meanings of HIV/AIDS shared by those who suffer with it and members of the wider culture. Both studies are used to examine the cultural contexts and underlying schemata (universal and local, cultural and biological), which are involved in the construction of cultural models of HIV/AIDS in Nepal.

This book represents the first long-term field study of the cultural dimensions of HIV/AIDS in South Asia. It is also one of the few ethnographies of HIV/AIDS to emphasize the depth and diversity of the people's view and construction of the emerging illness. And it is the only HIV/AIDS ethnography to utilize a discourse analysis (linguistic) approach.

Although this book is written primarily for scholars of Nepal, other scholars such as anthropologists (especially medical anthropologists), social epidemiologists and public health professionals (especially health educators working with international NGOs) would also enjoy the topics covered. It may also be of theoretical and methodological interest more widely to cognitive anthropologists, cognitive linguists and psychological anthropologists because it explores the relationship between cognitive schemata and the creation of cultural models of meaning and provides a better understanding of how people incorporate new ideas into established cognitive systems. Cognitive linguists would also be interested because the successful use of the narrative analysis method provides cross-linguistic validity to the discourse analysis model, a relatively new model of linguistic research.

David Beine holds a Ph.D. in anthropology from Washington State University (2000) and was affiliated as a research scholar with Tribhuvan University, Department of Sociology/ Anthropology, Kathmandu, Nepal during the tenure of his doctoral research (1998 2000). The findings of this research serve as the basis for this book.

Dr. Beine's interest in South Asia first began in 1988 when he traveled to India and Nepal to live for three years to conduct linguistic research that would later culminate in the publication of his linguistic anthropology Master's thesis, "A Sociolinguistic Survey of the Gondi-Speaking Communities of Central India" (San Diego State University, 1994), Following that he and his family again lived and worked in Nepal during 1995, 1998-1999 and 2000-2001. He currently resides with his family in Spokane, Washington and teaches summer courses in cultural anthropology in Eugene, Oregon. Dr. Beine also spends significant time in Nepal yearly and continues his involvement in applied anthropology and sociolinguistic research throughout the entire South Asia region.

He deceived me. He persuaded me promising to take me to a glittering town. He deceived me promising to take me on a running motorcar. He promised to employ me in the carpet industry and then told me to be happy with an income of one or two hundred rupees. I am a girl of the village and was easily deceived. I got entangled in the threads of the carpet looms. He told me he would take me into another profession. He said Raxaul as it sounded, but took me to Bombay. I learned that he had sold me for 12,000 rupees. He pushed me down into living hell.

That didi, the sinful woman, uttered sweet words, with smiles she said that my stars would now shine bright, but when I refused, I was beat. Don't ask me then through what hell I've been up till now! I spent nine years in that hell and my life was totally shattered. One day a cold caught me. I found myself with diarrhea and chest pains. One day a doctor came to give me a check up, the didi gestured, and I agreed.

She gave me 2000 rupees and a train ticket and they sent me home with many incurable diseases. I was not cured and my ailments made me desperate. The blood exam revealed that I have the fatal AIDS.

Alas, my life is reaching an end, and it ends in nothing then. O straight-forward girls of the village please look at me! Don't get coaxed in the sweet words of those sinful souls. (Ramesh 1993).

Book's Contents and Sample Pages