Title

The evolution of vulnerability: Ethnomedicine and social change in the context of HIV/AIDS among the Jola of southwestern Senegal

Date of Completion

January 2003

Keywords

Anthropology, Cultural|History, African|Health Sciences, Public Health

Degree

Ph.D.

Abstract

This dissertation serves two distinct purposes. First, it fills a void in the study of the Jola people of southwestern Senegal by providing the first comprehensive ethnomedical analysis of a Jola subgroup. Second, it examines the full range of circumstances that render young Jola adults vulnerable to the transmission of HIV/AIDS. The Jola people have undergone rapid and considerable social transformations in the last century. Drawing on historic, ethnographic and ethnoepidemiological data, the thesis traces the effects of these transformations on Jola healing, disease distribution, sexual relations, and reproductive practices. The breakdown of social control mechanisms within the family and fracturing relations between Jola elders and youth, and between women and men, are analyzed in relation to a burgeoning local health crisis. Close attention is also paid to the local effects of macrosocial forces, including Senegal's structural adjustment policies, ongoing regional conflict, and economic marginalization. The thesis presents the results of an extensive 99-village study detailing local healers' beliefs and practices regarding illness etiology and changing patterns of disease severity and distribution. A study of four living generations of women and men is also presented to show interrelations between the day-to-day lives of Jola individuals, couples, and families and the changing social context of sexual relations and premarital reproduction relevant to the transmission of HIV/AIDS. The thesis concludes by arguing that efforts to change individual behavior, such as the promotion of monogamy and condom use, will continue to fail in controlling the spread of HIV/AIDS in Africa if such efforts are divorced from the political economic forces that constrain individual behavior and ultimately pattern the distribution of the disease. ^