7 Chapters
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1. First Loves

Kathryn A. Rhine Indiana University Press ePub

1

First Loves

When I was a very young woman, men would compliment me a lot!” Amira, a married woman from Kano in her twenties, described to me:

When they said I was beautiful, I felt as if I was on top of the world. I felt so happy and proud among my friends. Then came my future husband, John. He kept on pursuing me … it was just a “boyfriend and girlfriend” routine. He would wait on the road outside my house to take me to school…. He was twenty-eight years old and I was a just a young girl. Let’s say around thirteen. He knew that lots of young guys were after me – younger than him. Good-looking guys! He dedicated a lot of time to me so that I would not escape from him. He would take me home after school. His car would be parked right at the school gate. I remember how my principal – who liked me so much – put me on suspension because of this. I was young and intelligent. She did not think John would allow me to focus on school. She thought I was too young for so much attention.

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Introduction: Things Unseen

Kathryn A. Rhine Indiana University Press ePub

Introduction: Things Unseen

2. The Unseen Things

Hope is in the tender hands that hold you.

Hope is in the embrace of the loving.

Hope is in the flesh touching flesh

to remind us of our human selves.

Hope is in the gentle nod of recognition,

hope is in the limping body still pushing

against the pain, the discomfort, still

laughing from so deep down it feels

like the rush of alcohol in the head

the full abandonment of all fear.

Hope is in the freedom to say

I long to be touched by a lover,

I long to feel the rush of desire

satisfied; hope is to embrace hunger

and find comfort in the sharing of needs.

Hope is in the hands we grasp,

the prayers we whisper,

the Amen, the Amen, the Amen.

Kwame Dawes, Faith

IN THE SPRING of 2003, I met with a young, widowed woman named Mary in an HIV clinic in the middle-belt city of Jos, Nigeria.1 It was a difficult interview, filled with many tearful pauses as she recounted her relationship history. Apart from the physicians and counselors in the hospital, I was the only person who knew she was infected with HIV. Mary’s narrative jumped back and forth in time. It was hard to understand. She was anxious and interrupted at numerous points to ask questions: about America, about her health, about the tape recorder. As Mary grew comfortable with me, more personal questions followed: Did I have a boyfriend? When would I marry? I stammered through my answers. Yet another interruption: “Katie,” she said, “I want your advice.” Mary paused. She then asked, “Can I get married?” I did not know what to say.

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4. Intimate Ethics

Kathryn A. Rhine Indiana University Press ePub

4

Intimate Ethics

In 2006, I sat in a counseling office at an HIV clinic with Patience, a close friend and key informant. She had worked there for a year as a treatment support specialist. Her day-to-day activities consisted of escorting patients from the lab to the physician’s office to the pharmacy. Patience complained that the medical director had asked her to provide guidance on “living positively” to a distraught patient. They hoped Patience would share her personal experiences with her. Although some of the staff members knew she was HIV-positive, many of her clients did not. The hospital policies did not require her to disclose her status, and she resented being asked to do so.

Like many other patients, this young woman believed that her life was over. Patience confronted the client. She said, “Look at my face. Do you know if I am positive or negative?” The woman said she thought she was negative. She continued, “How do you know this?” The woman responded that it was because she was so fat. “In fact,” Patience countered, “I am positive … so you see, you can live healthy just like everyone, as long as you take your medicine every day.” The medical lesson was clear: if you adhere to your treatment regimen, you will remain healthy. However, Patience also imparted to her client a social lesson implicitly understood by all of the women in that clinic’s waiting room: beauty – displayed through a curvy, welldressed body and modest, yet self-assured, comportment – is deceptive.

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3. Dilemmas of Disclosure

Kathryn A. Rhine Indiana University Press ePub

3

Dilemmas of Disclosure

Over the past two decades, the number of HIV counseling and testing centers in medical sites across Nigeria has grown exponentially. Women also receive HIV tests when they seek prenatal care in hospitals. Because these services are routinely offered, many wives learn their status without their husbands’ knowledge. They must then decide if and how to disclose the results to them. Counselors often complained to me about the difficulties they had trying to persuade women to bring their husbands in for screening. I asked one administrator how she managed this challenge. She told me confidently:

Well, the number one thing that can be done to ease this issue is counseling. When women attend HIV counseling, it goes over very well. But, there is a different way you counsel a man because … well, personally, this is the way I do it: I will write a note to the husband. I will say that I would like to see him in the hospital because I have an important issue to discuss with him regarding the baby. So, the moment they see this note, they are very eager … that, “a medical personnel wants to see me! Let me go and know what is happening.” And, when the man comes, that will be the only opportunity that I have to even sit down and counsel him…. Specifically, I tell men, “Okay, when women come to the hospital to deliver the baby, they may need a blood transfusion. And, because HIV is so rampant now, we need to screen your blood.” If you just tell men directly that it is an HIV test, they will not like it. You will say that they need to know their blood group, the genotype, and so on. “Without this blood information,” we say, “your wife might get blood from somebody, and you will not know whether the person is HIV-positive.” They will say, “No! No! No! Madam, please test me so that I will know my status, just in case … so that you can prepare for the birth.”

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Conclusion: Evidence and Substance

Kathryn A. Rhine Indiana University Press ePub

Conclusion: Evidence and Substance

There is substance in the gathering

of bodies battered by this disease.

There is evidence in the quiet promise

we make to be here again next week.

There is substance in the sweet taste

of coconut water, the scent of morning.

There is evidence in the songs a slim man

sings, healing as the balm of warmed oil.

There is substance in the expletives shattering

our peace, the tears, the lament, the fear.

There is evidence in the hum of recognition,

the comfort of hands held tightly.

There is substance in the streets walked

to tell people to hope for tomorrow.

Kwame Dawes, Faith

Throughout this book, I have documented the centrality of hope in HIV-positive women’s narratives of their lives: for health and wellbeing; for love, marriage, and children; for education, work, and economic prosperity; and for security and longevity. Through an ethnographic lens, I have located these dreams in women’s lived realities. Their aspirations for the future surface in scenes of youthful trysts and romantic encounters; in marriage celebrations and fearful wedding nights; in violent encounters with abusive husbands and futile pleas for help from family members; in hidden pregnancies and joyous presentations of baby pictures; in elaborate beauty regimens and conspicuous displays of generosity to relatives, neighbors, and researchers; in successful entrepreneurial businesses and uncompensated, arduous household labor. These women’s steadfast faith – in God, in the virtue of family, in a meaningful life, in a cure for their disease – grounds these hopes as they face formidable daily struggles. Amid the changes ushered in by global initiatives centered on increasing access to HIV treatment and medical services in Nigeria, theirs is a story of continuity.

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