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Discourse, Disease and Displacement: Interrogating Selected South African Textual Constructions of Aids

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Discourse, Disease and Displacement: Interrogating Selected South African Textual Constructions of Aids DISCOURSE, DISEASE AND DISPLACEMENT: INTERROGATING SELECTED SOUTH AFRICAN TEXTUAL CONSTRUCTIONS OF AIDS by FELICITY JUNE HORNE submitted in accordance with the requirements for the degree of DOCTOR OF LITERATURE AND PHILOSOPHY in the subject ENGLISH STUDIES at the UNIVERSITY OF SOUTH AFRICA SUPERVISOR: Dr G. Graham-Smith CO-SUPERVISOR: Prof. B. Spencer JUNE 2010 2 DEDICATION Dedicated to my late parents Margaret and Billy Kirk for giving me a love of the English language and books. 3 DECLARATION I declare that this thesis, entitled ‘Discourse, Disease and Displacement: Interrogating Selected South African Textual Constructions of AIDS’, is my own work and that all the sources that I have used or quoted have been indicated and acknowledged by means of complete references. Signed: 4 Discourse, Disease and Displacement: Interrogating Selected South African Textual Constructions of AIDS SUMMARY This thesis explores the theme of displacement in AIDS (Acquired Immune Deficiency Syndrome)-related discourse in post-apartheid South Africa in the period 1994−2010. It contends that the subject of AIDS and the AIDS-ill is seldom confronted directly in the discourse, but displaced in various ways. Using the theory of social constructionism and the discourse theory of the French poststructuralists, particularly Michel Foucault, selected texts, both literary and non-literary, are subjected to discourse analysis, in which the interrelationships between linguistic and visual representations of AIDS, practice, knowledge and power relations are examined. Recognising that all representations are to some extent displaced constructions, the thesis investigates additional reasons for the particular kinds of displacement of AIDS seen in AIDS discourse. These include stigma, fear, defensiveness and the enduring power of pre- existing discourses onto which AIDS is grafted. In narratives by and about the AIDS-ill, personal stories are displaced when mythical structures are used to give meaning to what could otherwise be viewed as futile, random suffering. As a result of the different displacement devices employed in AIDS discourse, new meanings of AIDS are constructed, related to the social, political and cultural context out of which they have arisen. The thesis comprises five chapters, each of which explores a different form of displacement. In Chapter 1, ‘Displacing AIDS through Language’, the focus is on language as a form and means of displacement; Chapter 2, ‘Politicising AIDS’ explores the way that AIDS discourse is projected onto the larger, well-established discourse of politics, and specifically on the discourse of ‘the struggle’ against apartheid; while Chapter 3, ‘Satirising AIDS’, considers the way that satirists displace AIDS through irony, exposing the contradictions and absurdities inherent in the discourse. Chapter 4, ’Gendering AIDS’, shows the extent to which AIDS-related discourse is articulated to gender-related issues such as unequal power relations between men and women and stereotypical views of women’s identities and ‘proper’ roles. The final chapter, Chapter 5, ‘Narrating AIDS’, deals with the discourse of personal illness narratives, showing how individuals displace the experience of illness through narrative, often using the structures of myth to give meaning to their experience. Key terms: HIV; AIDS; South Africa; discourse; discourse analysis; displacement; representations; social constructionism; texts; language; politics; satire; gender; narrative. 5 Discourse, Disease and Displacement: Interrogating Selected South African Textual Constructions of AIDS TABLE OF CONTENTS Pages Title Page 1 Dedication 2 Declaration 3 Summary 4 Table of Contents 5 Acknowledgements 6 Key Terms and Acronyms 7 INTRODUCTION 9 CHAPTER 1: DISPLACING AIDS THROUGH LANGUAGE 38 CHAPTER 2: POLITICISING AIDS 82 CHAPTER 3: SATIRISING AIDS 124 CHAPTER 4: GENDERING AIDS 165 CHAPTER 5: NARRATING AIDS 211 CONCLUSION 258 REFERENCES 264 6 Acknowledgements I would like to thank: UNISA for the Research and Development leave which gave me the precious gift of time to conduct this research, and for funding my attendance at two overseas conferences: San Antonio (Texas) in 2004 and Belfast (Northern Ireland) in 2007, where I presented papers on aspects of this research; UNISA Library Services and particularly Mr Dawie Malan for invaluable assistance; Prof. Hilton Hubbard for giving me his time and advice in a very helpful conversation when this thesis was just the germ of an idea; Jonathan Shapiro for his kind permission to reproduce selected cartoons in this thesis; my cousin, Dr Heather Crewe-Brown, for the loan of medical journals and assistance with a research query; my colleagues and friends in the Department of English Studies at UNISA for their support and encouragement, and for the faith they have shown in me; my dear friend Norah, for reading the entire manuscript, and her continuing interest and encouragement; my family: my daughter Julia for her technical help and for standing by in the crucial final stages of printing; my daughter Fiona for keeping me informed about lectures and events held at Wits; my son Ross for making my life interesting and keeping complacency at bay; and my husband Tony for his protectiveness, support and belief in my ability to complete this project on time; my supervisor Greg for his comments, final editing and Bibliographical expertise; my co-supervisor Brenda for her responsiveness to my ideas and belief in the value of this research; and for generally enabling this thesis to reach fruition. 7 Key Terms and Acronyms ABC Abstain; Be Faithful; Condomise (Government AIDS-Education Campaign) ANC African National Congress AIDS Acquired Immune Deficiency Syndrome ARV Antiretroviral: medication which inhibits the replication of the HI-virus AZT Zidovudine: an antiretroviral treatment AWB Afrikaner Weerstandbeweging (Afrikaner Resistance Movement) CD4 a cell in the immune system which is attacked by the HI-virus CD4 count the number of immune cells in the blood, used as a measure of immune function in the body HIV Human Immunodeficiency Virus MSF Médecins Sans Frontières (Doctors without borders) MTCT Mother-to-child transmission Nevirapine An ARV used to treat HIV-positive pregnant women TAC Treatment Action Campaign TB Tuberculosis UNAIDS Joint United Nations Program on HIV/AIDS WHO World Health Organisation HIV-positive and AIDS To be HIV-positive indicates that a person has been infected with the HI-virus, but is not symptomatic: they will generally appear and feel healthy. AIDS is the disease syndrome that eventually results from this infection. The time delay between HIV-infection and manifestation of the symptoms of AIDS varies, but can take many years. Being HIV-positive and having AIDS are therefore two separate, but related conditions. It is now customary to use the compounds ‘HIV/AIDS’ or ‘HIV and AIDS’ to refer to the condition, but to avoid clumsiness I have chosen to use the term AIDS in this thesis in a generic way, except when referring specifically to the HI-virus, which I term ‘HIV’. Discourse ‘Discourse’ is understood differently according to which field or school uses the term. In the discipline of Linguistics, ‘discourse’ is synonymous with ‘text’, and refers to a stretch of language, spoken or written. The European or ‘Continental’ School, represented chiefly by Michel Foucault, understands ‘discourse’ in a more broad and abstract way which includes knowledge systems, social practices, visual texts and other forms of semiosis, as well as linguistic texts. Discourse is seen as a human construct which brings an object into being, or produces a social reality. Discourse is inaccessible in its entirety, but traces of it are found in the texts that help to constitute it. This school holds that discourses reflect and shape the power structures in society. Discourse constructs identities by defining groups, their interests and their status in society. 8 It labels, classifies and organises social structures. However, such constructs are not fixed or stable. In this thesis, I draw on both these strands of meaning. Many of the texts on which this study is based are linguistic or literary, but some constitute cultural events and abstract phenomena such as bodies of knowledge and schools of thought and opinion. Discourse Analysis Following from the differences in the way the term ‘discourse’ is understood’ (explained above), ‘discourse analysis’ cannot be seen as a single methodology. When used in the field of linguistics, it involves the examination of the language of texts at the micro-level of language use, as well as a consideration of the connections between different texts, and their context. This is known as ‘textually-oriented discourse analysis’ (TODA) (Fairclough 1992: 37). According to the Foucauldian tradition, ‘discourse analysis’ involves the analysis of texts (where ‘texts’ are seen as more than linguistic artefacts) to demonstrate how these contribute to the creation of social realities, including institutions and cultural entities (‘discursive formations’). This involves a consideration of the power relations and discursive inequalities that operate in society. Here again, my study draws on both these traditions, and I employ a synthesis of both approaches in my analyses. Disease ‘Disease’ refers to the way medical discourse views, labels and constructs health problems. ‘Disease’ is distinguished from ‘illness’, which refers to the patient’s experience of ill health. This corresponds with Kleinman’s
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