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.

[Social capital, from sociology to epidemiology: critical analysis of a transfer across disciplines].

In recent years, social capital has emerged in epidemiological studies as a new concept, improving our understanding of the relationships between social inequalities and health inequalities. This concept, borrowed from social sciences, has three distinct sociological sources. However, only the most recent theory, which emphasizes the role of civic trust and is useful for analysis at community level, has been used in epidemiological studies.

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).

[Prevalence of rheumatic manifestations in human immunodeficiency virus infection].

Unlabelled: Various rheumatic manifestations have been reported in HIV infected patients, but the prevalence of these manifestations is not well known. Therefore, we have designed a prospective study to define the rheumatic manifestations in those patients.

Methods: 121 patients (stage IV of CDC classification) were assessed by physical examination and biological tests.

[Physical handicapped, economic practices and matrimonial strategies in Senegal].

Social relations around the handicapped are generally presented in terms of economic dependence and social inadaptation. This point of view leads to give greater importance, especially in Africa, to studying the way in which group and society help the physically or mentally ill. Actually, this approach does not give a complete account about the real situation of the handicapped in social relations of production and reproduction.

[Utilization of health statistics in peripheral structures in developing countries].

Health information in developing countries serves mostly to diseases notification and activity registration, but rarely is it used for analyzing the health status of populations or the results of health intervention. Moreover, it is stored at a national level, mainly to fill monthly or yearly reports, and very seldom at a peripheral level where it would be probably more helpful. On the basis of experiences realized in Senegal and Nepal, we try to answer the two following questions: how to make health statistics utilizable, i.

Immunization coverage and social differentiation in urban Senegal.

We studied sociocultural factors associated with immunization coverage among a random sample of 500 mothers in the underprivileged suburbs of Dakar, Senegal. Factors associated with immunization of children under age 5 were maternal educational level and socioeconomic conditions (especially husband's regular salary); maternal age on arrival in town was more influential than total number of resident years in town; no effect of ethnicity was evident.