Kimberly Vrudny

Overview

During graduate school, as I studied religious responses to the great plague of 1347, I could not help but to notice parallels to the HIV/AIDS pandemic of our own day. Just as priests in the Middle Ages believed plague came as a punishment from God for sinful deeds, like gambling and prostitution, so did we hear pastors preaching from their pulpits that AIDS was God’s punishment unleashed on a sinful humankind. Just as those falling ill with fevers were ostracized from the community in medieval Europe, so were those acquiring opportunistic infections shunned in many communities in the United States, in Europe, in Africa, and in Asia. And, just as some—just a few, really—responded courageously in the Middle Ages, providing relief when the stress of illness seemed to overcome all else, so did few at first, but more over time, offer friends and loved ones assistance as AIDS shut down immune systems, killing one, then one thousand, then one million. . . .

Noticing these parallels, it was only a matter of time before I became actively involved in HIV/AIDS response. For much of the past decade, I have been immersed in an interdisciplinary study of theology, public health, and photography—which has led, finally, to the photographs and scholarly essays that, together, comprise “30 Years / 30 Lives.” By working locally with an organization that provides meals to those living with the virus, and by traveling to places where prevalence rates are among the highest in the world, I have learned a great deal about human dignity, about compassionate resistance, and about living with integrity.

While these were not my first immersions into communities exuding resilience in the face of poverty, hunger, substance abuse, and violence—this work did mark a turning point for me as I continue to discern how best to invest my personal and professional energies. My husband and I were both granted sabbaticals from our teaching positions for academic year 2009-2010. We withdrew our children, then ten and five, from their public school systems in Minnesota and flew to South Africa where we lived, served, worked, and played for seven months. During that time, I had the great privilege of visiting many organizations responding to the structural drivers of the pandemic. In the second half of the year, I traveled also to Thailand and to Mexico in order to present a more demographically representative collection. Together with photographs of people in the United States, 30 people ultimately shared their perspectives about HIV/AIDS for “30/30,” providing the world with something of a mosaic of HIV/AIDS as the world marks the thirtieth year of our awareness of the presence of the virus in the human community.

Breathing in the ocean from our seaside cottage in South Africa, and at times contributing to it in tears, I have envisioned a world where we recognize our interconnectedness—our interdependence on one another, and on the earth that sustains us. May the real presence of Beauty in these portraits, the same One who revealed a vision of ubuntu to me in Africa, stir in us a desire to care for one another, face to face. —kv, 11/2010.

OVERVIEW

As the world community approaches the thirtieth year of the HIV/AIDS pandemic, “30 Years / 30 Lives” aims to recalibrate our vision by introducing viewers to thirty individuals in the United States, South Africa, Thailand, and Mexico whose lives have intersected in some way with HIV/AIDS, whether through care for or loss of a loved one, engagement in humanitarian response, or acquisition of an infection personally.

Each individual in “30/30” is affiliated with an organization that is responding to a structural driver of the pandemic. After conducting research to identify these underlying issues, and to locate organizations responding to each one, the photographer requested a meeting with administrators of each organization to introduce them to the project, and to request permission to include the work of their organization in “30/30.” Upon agreeing to participate, administrators of each organization identified three individuals to represent their organization. Each signed a consent agreement, giving the photographer permission to take a portrait, and to publish the words each would share by writing into a common journal in response to the invitation: “tell us about you, and your thoughts about HIV/AIDS as the world approaches the thirtieth anniversary of the pandemic.” All participants received an 8” x 10” enlargement of their portraits as well as an 8” x 8” print of the portrait placed into a still life arrangement. Participants agree to waive their rights to the sales of their photographs, recognizing that only the organization with which they were affiliated—neither the individual participant nor the photographer—would receive any potential profits from sales.

The project aspires to raise awareness about the structural dimensions of HIV/AIDS in order to challenge commonly held assumptions about who is affected, and to encourage a just and compassionate response to what has been called the worst human rights disaster in history. By highlighting the work of ten organizations responding to socio-economic issues that the pandemic puts into sharp relief, “30/30” documents the structural drivers of HIV/AIDS, exploring how the virus proliferates when the public is complacent, content to tolerate:

1. ridiculously high levels of poverty and hunger
2. religious fundamentalism
3. xenophobia
4. inequitable access to healthcare
5. violence against women
6. illiteracy, and inequitable access to education
7. mistreatment of elders and orphans
8. AIDS denialism
9. human trafficking
10. political violence

1. Ridiculously high levels of poverty and hunger. Paul Farmer, a medical anthropologist at Harvard and a practicing physician, perhaps more famously than anyone has brought attention to the intersections between poverty and AIDS by opening clinics in some of the poorest and most remote areas of the world. He has proved to skeptics that, with proper counseling and access, people without financial resources are able to maintain a pharmaceutical regimen, even one as complex as that to treat an HIV infection. Such treatments are most effective when taken with stomachs that are made full by nutritious foods. Recognizing that hunger and malnutrition are issues for people living with HIV/AIDS in Minneapolis, just as they are for people in Haiti and Sub-Saharan Africa, Open Arms of Minnesota prepares meals for and delivers meals to people living with and affected by HIV/AIDS in the Twin Cities. In the “30/30” still life photographs, Open Arms of Minnesota is signified by a red rose, a symbol of pride, because in Minnesota the virus is still disproportionately prevalent in the gay community.

2. Religious fundamentalism. Some Christian churches throughout the world claim that HIV/AIDS is God’s will—a punishment for behaviors thought to be sinful such as homosexual sex, promiscuous sex, and intravenous drug use. When confused believers ask about the presence of the virus in victims of rape or in the bodies of children, preachers have responded that HIV is a test sent by God to see if God’s people will respond compassionately. Such frameworks avoid a sincere grappling with the role of religion in judging, shaming, and stigmatizing those testing positive. They also prevent people from wrestling with the ways in which they have perpetuated the conditions in which HIV proliferates. The J. L. Zwane Church and Community Center in Guguletu was among the first in the Western Cape of South Africa to encourage those testing positive to live openly in the community, with the church’s acceptance and embrace. In the “30/30” still life photographs, the J. L. Zwane Center, affiliated with the Presbyterian church, is signified by a sunflower, a symbol of faith by grace.

3. Xenophobia. The irrational fear or distrust of those who are different from oneself, xenophobia is countered by xenophilia—a love, acceptance, and embrace of “foreigners” or “otherness” that is fostered by face to face encounters. The Scalabrini Center, an organization with Catholic roots in Italy that welcomes refugees and asylum seekers to Cape Town by assisting newcomers with immediate needs as well as with life skills to enable thriving in a new environment, conducts voluntary testing and counseling through its “Ukukhanye Kwetemba” or “Sunshine of Hope” program. In the “30/30” still life photographs, the Scalabrini Center is signified by a strawberry, a symbol of good works.

4. Inequitable access to healthcare. Because of the legacy of apartheid in South Africa, the infrastructure to handle a pandemic the scale of HIV/AIDS was not in place when the new democracy was first in power. The country did not effectively distribute information about how to prevent infection, nor could it provide widespread testing and delivery of treatment. Moreover, because indigenous forms of the healing arts were widely thought to be in competition with scientific approaches to medicine, not to mention trials conducted by (white) European and American doctors on African and African American populations in the past, there was a severe distrust of Western medicine in Africa when the epidemic first became evident in South Africa. Access to quality healthcare in South Africa remains inequitable. All the same, primary health care clinics, such as Inzame Zabantu in Philippi, a township outside of Cape Town, have been built in the post-apartheid situation, and are successfully providing testing and treatment to some among the 1,400 people a day who are testing positive with HIV/AIDS in South Africa (6,000 a day worldwide). In the “30/30” still life photographs, the Inzame Zabantu Community Health Center is signified by a hibiscus flower, a symbol of good health.

5. Violence against women. Women are more vulnerable to an HIV infection than men biologically, culturally, and socially. Because of the greater surface area that can receive the virus when bodily fluids are passed during intercourse, women are more vulnerable to an infection than are their male counterparts. This is compounded by socio-economic and socio-cultural conditions. Sexual promiscuity is the norm for men in many cultures, putting women who have been faithful to their husbands in jeopardy. Situations persist where women are treated as if they were intrinsically inferior to men. Many are in cycles of domestic violence, dependent upon men for their survival, and not at liberty to request protection in sexual encounters. Misogyny persists, such that women are, for example, blamed when they are raped for having tempted the male perpetrators of the crime, an insult compounded where men are taught that raping a virgin cures HIV. Often denied an education and abandoned, women sometimes are desperate to feed the children for whom they are primarily responsible. Some will turn to the sale of sex in order to feed themselves and their children. Recognizing how women are vulnerable to an infection given these realities, Wola Nani intervenes to support women, offering a means of income generation in addition to psychosocial support. In the “30/30” still life photographs, Wola Nani is signified by the calla lily for its uniquely South African concept that “through our embrace, we develop one another.”

6. Illiteracy, and inequitable access to education. In 2008, 17% of the world’s adult population was estimated to be illiterate. Research has shown that the vocabulary of children from economically disadvantaged backgrounds lags a year or more behind classmates of children from more advantaged homes. In South Africa, where the population continues to feel the effects of apartheid, children of color continue to perform more poorly on literacy tests than their more privileged counterparts. Yabonga, an organization that supports children, women, and men testing positive to live healthfully and positively, has established educare centers to provide support to South Africans in order to decrease the achievement gap, as well as to provide high-quality testing and counseling services to people living in underprivileged areas. In the “30/30” still life photographs, Yabonga is signified by the plumeria, which symbolizes shelter or protection, its five petals symbolizing the quest for perfection through sincerity, faith, devotion, aspiration, and surrender.

7. Mistreatment of elders and orphans. In 2004, the UN published a volume called The Impact of AIDS, reporting how HIV has affected the world’s ability to staff hospitals, schools, farms, and so on, to support the world’s increasingly global economy. The volume also discusses the impact of AIDS on households, noting how vulnerable persons, such as elderly people and orphans, have been adversely impacted by HIV/AIDS. In South Africa, for example, where the middle generation has been devastated by the pandemic, the elderly have been impacted profoundly. Under the new government in South Africa, people aged sixty-five and over receive a monthly pension of R800 (about $100), to assist them to maintain a minimum standard of living. Many pensioners find themselves taking on primary caregiving responsibilities for grandchildren, paying school fees and providing food, shelter, and clothing for the little ones whose parents have succumbed to the virus. In some cases, orphans and pensioners are targeted by gangs, since it is widely known when money is distributed. Others are abused by their own children, who steal the money to support their own ambitions, addictions, and so on. These are the situations to which Ikamva Labantu has responded with an innovative program to support elders in communities throughout the Cape Flats. In the “30/30” still life photographs, Ikamva Labantu is signified by the lotus flower, which symbolizes the struggle for life and how it blooms in old age—for the lotus only flowers after it has emerged from the mud and muck from a river bottom or lakebed.

8. AIDS denialism. Dissident groups of AIDS denialists challenged accepted science on a horrific scale when Thabo Mbeki, the African National Congress leader who succeeded Nelson Mandela as President of South Africa, refused to admit that HIV is the biological cause of AIDS. Believing that pharmaceutical companies were in collusion with medical authorities to make profits off of common illnesses that affect the poor, Mbeki’s refusal to link HIV with the syndrome of opportunistic infections that the virus creates as it shuts down the immune system threatened his population. As a result, many people in South Africa failed to protect themselves during sexual encounters, and others refused medications that could have saved or prolonged their lives. A study conducted by Harvard University suggests 365,000 people died unnecessarily as a result. The Treatment Action Campaign, a public advocacy group attempting to ensure that every man, woman, and child has access to affordable treatment for HIV/AIDS, lobbies to make pharmaceutical therapies as well as medications to prevent mother-to-child infections affordable and accessible in South Africa. Its work continues to ensure equal treatment for all. In the “30/30” still life photographs, the Treatment Action Campaign is signified by the white chrysanthemum, which symbolizes truth.

9. Human trafficking. In his book Women, Poverty, and AIDS: Sex, Drugs, and Structural Violence, Paul Farmer introduces readers to several women from all around the world whose stories, though different in detail, are eerily similar. His point is that, when girls and women are poor, they are vulnerable. Sometimes their fathers send them far from home in response to an advertisement that factory workers are needed—only to realize too late that they have been tricked into enslavement in a brothel. In other situations, girls are intentionally drugged in order to addict them, making them dependent upon the pimps and madams who profit from the services they provide to customers. This kind of forced or coerced recruitment, transportation, transfer, harboring, or receipt of persons, known as human trafficking (or the modern-day slave trade) has contributed to HIV/AIDS infection rates. The New Life Center Foundation supports ethnic minority girls and young women throughout the Mekong sub-region of Thailand who are at risk for, or victims of, labor exploitation, human trafficking, and sexual abuse, partnering with the Royal Thai Government and national NGOs to confront these problems collaboratively and to provide holistic care. In the “30/30” still life photographs, the New Life Center Foundation is signified by the presence of the orchid, which symbolizes strength and innocence.

10. Political Violence. Political violence, or the direct forms of violence that are used by governments, militaries, paramilitaries, and peoples to achieve political ends, is a driver of HIV/AIDS infection rates. The brutal practices of the apartheid government in South Africa, the social unrest in Thailand, as well as the low-intensity warfare against the indigenous people of Mexico, for example, put vulnerable populations at higher risk for public health disasters, including HIV/AIDS, by forcing migration, increasing poverty rates, and limiting access to education and healthcare. In 1994, on the same day that the North American Free Trade Agreement (NAFTA) went into effect, for example, a group of indigenous persons led an uprising in Mexico. They protested their government’s alleged violation of the 27th amendment of the Mexican Constitution, protecting indigenous lands from corporate and national acquisition. They presented a thirteen-point list of goals for their movement, pointing to aspects of their lives that were substandard under the Mexican government: land, work, labor, nutrition, education, health, shelter, communication, culture, independence, democracy, liberty, and peace. The community’s struggle for autonomy continues to this day. They have refused to accept government assistance, meaning that they are on their own in relation to education and healthcare. OMIECH, the Organización de Médicos Indígenas del Estado de Chiapas, provides training and herbal remedies to indigenous communities through a network of traditional healers, midwives, and health promoters. In the “30/30” still life photographs, OMIECH is signified by the presence of the lily, representing hope, and the nicotiana flower (tobacco), a plant sacred to the Mayans for its healing properties.

“30 Years / 30 Lives” grows out of a conviction that the basic problem with how the public responded to the pandemic initially, and continues to respond to this day in many ways, is fundamentally a problem of vision. By peering at the pandemic’s victims as expendable, many in the human community displayed a troubling lack of insight. Some, however, demonstrated an alternative way of seeing. Where others only saw deformity, some recognized the dignity of people living with HIV. Where others saw a lacking of being, some noticed the value that is inherent in every human life. Where others observed nothingness, some responded with compassion to the diminished state of another. “30 Years / 30 Lives” invites viewers to look, trusting that the real presence of Beauty in these images will capture our gaze, transforming us to envision the world anew, and empowering us to breathe a more peaceful common existence into being.

Bibliography

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