A case for critical ethnography: rethinking the early years of the AIDS epidemic in South Africa.

The epidemic of AIDS in South Africa has been characterized not only by its rapid progression but also its impassioned controversies. Retrospectively examining a long-term anthropological project and discussing some reactions it elicited, the paper proposes a defense and illustration of a critical ethnography at three moments of the research. Ethnography is first discussed as fieldworks, proposing an alternative to the horizontal multi-sited approach via a vertical multi-layered method using various scales and locations, and thus connecting the disease endured by patients in townships and former homelands with the heated debates in scientific and political forums: this procedure substitutes a political economy of the disease for its cultural and behavioral interpretations.

Negotiating care: patient tactics at an urban South African hospital.

Objectives: To examine the various ways in which patients sought to influence the care they received in the admission and adult medical services of a large urban, academic hospital in South Africa. These included the steps taken by patients to increase their access to services and improve their experience of care.

Methods: Part of a qualitative study of rationing behaviour, the methods combined, observations, interviews and a survey.

The elementary forms of care: an empirical approach to ethics in a South African Hospital.

Ethics is generally seen as the application of universal and intangible principles. Empirical studies then consist in verifying the degree of adequacy of practices to the norms. Here, conversely, ethics is considered as everyday practice: professionals, whether nurses or doctors, act within routines and under constraints, and later give an account of their action.

An anthropological hybrid: the pragmatic arrangement of universalism and culturalism in French mental health.

As in most European countries, the mental health of immigrants in France has recently been the subject of scientific scrutiny. Since the end of World War II voluntary special mental health services for migrants and refugees have been created in France and especially in Paris, but none has been based on epidemiological data. Generally, this lack of objective data gave rise to the assumption that many immigrants might not be getting the type of services they required.

[The origins and foundations of social inequalities in health].

France presents the paradox of being the country where the health system has been ranked first in the world for its overall performance and where the inequalities of mortality among men are the highest in Western Europe. This reality is little known, in part because it is little studied. The authors show how the issue of health inequalities has been recently re-discovered by researchers and scientific institutions.

Plumbism reinvented: childhood lead poisoning in France, 1985-1990.

Although the history of childhood lead poisoning started a century ago in the United States, the first French cases were identified in 1985. Instead of merely adopting knowledge accumulated for decades, the public health professionals and activists involved had to reestablish, against incredulity from medical authorities and resistance from policymakers, all the evidence: that children were the main group concerned; that cases were not isolated but part of an epidemic; that wall paint in old, dilapidated apartments was the source of contamination; and that poor housing conditions, and not cultural practices, were responsible for the high incidence in African families. This "reinvention" illustrates more general sociological phenomena: discontinuities in medical history, strength of culturalist prejudices toward immigrants, resistance to socioeconomic interpretations of disease, and struggles between different perspectives in public health.

The embodiment of inequality. AIDS as a social condition and the historical experience in South Africa.

AIDS as a social condition and the historical experience in South Africa

Embodied history. Uniqueness and exemplarity of South African AIDS.

The exceptionality of AIDS in South Africa, both for its epidemiological features and public controversies, seems to have its correspondence in the exceptionalism of South African history, with its unprecedented regime of apartheid and its unexpected turn to democracy. The article shows that AIDS in this country can simultaneously be seen as unique (because of the historical context in which it is inscribed) and exemplar (of social determinants observed in other countries characterised by similar past or present of domination). As an alternative to cultural and behavioural models of the epidemic which have been widely spread on the African continent, the concept of embodiment of history is proposed in order to account for both the structural facts underlying the epidemic (inequality, violence, migration) and the construction of collective as well as individual narratives of the disease (including victimisation and accusation).