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Theatres of HIV and Complexity in South Africa Jessica S Washington University in St. Louis Washington University Open Scholarship Arts & Sciences Electronic Theses and Dissertations Arts & Sciences Winter 12-15-2014 When Life Happens: Theatres of HIV and Complexity in South Africa Jessica S. Ruthven Washington University in St. Louis Follow this and additional works at: https://openscholarship.wustl.edu/art_sci_etds Part of the Anthropology Commons Recommended Citation Ruthven, Jessica S., "When Life Happens: Theatres of HIV and Complexity in South Africa" (2014). Arts & Sciences Electronic Theses and Dissertations. 338. https://openscholarship.wustl.edu/art_sci_etds/338 This Dissertation is brought to you for free and open access by the Arts & Sciences at Washington University Open Scholarship. It has been accepted for inclusion in Arts & Sciences Electronic Theses and Dissertations by an authorized administrator of Washington University Open Scholarship. For more information, please contact [email protected]. WASHINGTON UNIVERSITY IN ST. LOUIS Department of Anthropology Dissertation Examination Committee: Carolyn Sargent, Chair Peter Benson Jeffrey Q. McCune, Jr. Shanti Parikh Bradley Stoner Julia A. Walker “When Life Happens”: Theatres of HIV and Complexity in South Africa by Jessica S. Ruthven A dissertation presented to the Graduate School of Arts and Sciences of Washington University in partial fulfillment of the requirements for the degree of Doctor of Philosophy December 2014 St. Louis, Missouri © 2014, Jessica S. Ruthven Table of Contents Acknowledgements………………………………………………………………….……….….vii Abstract……………………………………………………………………………….........….…xi PART 1: SETTING THE STAGE: BACKGROUND AND THEORY…………………..…1 CHAPTER 1: Introduction…………………………………………………………………...……………….…2 1.1 Applied Health Theatre 1.2 Research Objectives and Major Findings 1.3 Research Design: Sampling, Methods, and Geography of Research Sites 1.4 Organization of the Dissertation and Main Arguments CHAPTER 2: Medical Anthropology and Performance Studies: Literature and Theory……………........44 2.1 Medical Anthropology and HIV/AIDS: Shifting Practices in Ethnography 2.2 Performance Studies: The Betwixt and Between 2.3 Integrated Perspectives: Performance and (Medical) Anthropology PART 2: HISTORY AND CONTEXT……………………………………..………….….…..66 CHAPTER 3: Epidemiology, History, and Political Economy of HIV/AIDS in South Africa…..…….…...67 3.1 Epidemiology Demographics HIV Prevalence, Incidence, Mortality, and Trends Statistical Limits in South Africa Key Populations and Risk Groups South Africa’s Epidemic in Context: Comparison to Sub-Saharan Africa 3.2 Setting the Scene: Political Economy and Historical Context History, Structural Violence, and National Response to HIV/AIDS Apartheid and the Social Roots of South African HIV/AIDS Intervention (1948-1994) Key Legislation: Apartheid Legislative Program Early National Party Response: Apartheid Government and HIV/AIDS Policy (1982-1994) Contemporary HIV Policy (1994-2014) Transition from Apartheid to Democracy: The Mandela Era (1994-1999) Post-Apartheid HIV/AIDS Policy and Politics: 1999-2008 (The Mbeki Era) South African National AIDS Council (SANAC) Politics, Discourse, and Controversy: Government Denialism and ARV Provision Third ANC Government: Thabo Mbeki and HIV/AIDS Policy 2004-2008 Post-Apartheid Contemporary HIV/AIDS Policy: The Zuma Era (2009-Present) 3.3 Conclusion ii CHAPTER 4: Applied Theatre: Period of Reflection……………………………………………………..….99 4.1 “Commercial” vs. “Applied” Theatre: The Politics of Space and Language 4.2 Applied Theatre in Apartheid South Africa Township Theatre Protest Theatre 4.3 New Developments in Post-Apartheid Theatre Trends in Commercial Theatre Emergence of Arts Festival Circuit and Festival Culture Applied Theatre: Changes in Content, Practice, and Aesthetics 4.4 Rise of HIV/AIDS Theatre (1994-2014) 4.5 Narratives of Innovation Reacting to the Past Rigidity in Intervention Practices Underestimating Nuance Broader Health Industry Divisions Creative Risk 4.6 Conclusion PART 3: “WE NEED A NEW WAY:” COMPLEXITY, THE ARTS, AND HEALTH INTERVENTION …………………………………………………………………………….135 CHAPTER 5: Complexity Aesthetics……………………………………………………………….………. 141 5.1 Shifts in Genre and Practice 5.2 Health Arts Sector: Stakeholders and Innovators Performance: Key Players Then and Now Other Stakeholders Festivals 5.3 Moving Toward Syncretic Theatre: Mixed Approaches Uhambo: Pieces of a Dream It’s About Time (Joale Ke Nako) Training in New Styles 5.4 What Syncretic Theatre Adds: Power Dynamics, Fluid Aesthetics, and Alternative Healing Preachy Styles, Power, and Process over Product Process Drama: “Beautiful Power Play” “Allowing Conversations to Happen” and “Moving with the Times:” From Rigid to Syncretic Aesthetics The Dynamic Post-Apartheid Era Site-Specificity and People Needing Different Things at Different Times Alternative Ideas about Healing Dramatherapy: Healing through Integration Playback Theatre: Healing through Acceptance 5.5 Conclusion iii CHAPTER 6: Complexity: Language and Optics……………………………………………………….….196 6.1 Goals of the Present Not Limited to Goals of the Past 6.2 The Turn to the “Complex” 6.3 Ethnography of Theatre, Health, and Complexity Jorrell’s Story: Sexually Yours Noluvuyo’s Story: Violated 6.4 Unpacking Art and Subjective Complexity 6.5 Theatre of Moments and Shadows A Theatre of Moments Moments and Impact “Moments” as a Construct A Theatre of Shadows A Language of Shadows “Shadows” as a Construct 6.6 Discussion: Complexity and New Agendas in Post-Apartheid HIV/AIDS Intervention The Not-Fully-Known The Links between System and Experiential Complexity: Fomenting Interdisciplinary Dialogues 6.7 Conclusion PART 4: PUTTING COMPLEXITY IN ACTION: THEATRE AS A HEALTH INTERVENTION …………………………………………………………………………….253 CHAPTER 7: Complexity in Action: Acknowledging Incoherence……………………………………..…274 7.1 Fragmented Selves in Non-Judgmental Spaces 7.2 Acknowledgment as Recognition: Embracing Shadows and Meeting Truths Deep Night: Forgotten Angle Theatre Collaborative Bongani Recognition of Incoherence and Fragmentation 7.3 Acknowledgment as Challenging Intervention Language and Reassessing Health Activism Naomi, Problems, and Image Theatre Building a Vocabulary Outside of “Problems” and Implications for Social Change 7.4 Conclusion CHAPTER 8: Complexity in Action: Creating Reflexive Health Subjects…………………………..……315 8.1 Living the Questions, Living the Consciousness 8.2 Challenging the Scope and Techniques of Reflexivity Theatre Game: 1 to 10 Creating Space for Cognitive Reflexivity Producing Reflexive Health Subjects: Increasing Levels of Commitment and Integrating Multiple Domains of Experience Personal Stories and Method Acting Mining Intuitive Knowledge and Grotowski iv Uncomfortableness and Vulnerability Mindfulness and Brecht 8.3 Discussion: Producing Consociated Subjects and Reassessing Health Activism Rethinking the Individual: From Neoliberal Biocitizen to Consociated Subjectivity “Our Story: Nhlanhla’s Journey” Biocitizenship and Health Policy Discourse: Embracing Neoliberalism in South Africa Relationality and Consociation: Complicating Understandings of “The Individual” Health Subject Relationality and Anthropology Reflexivity, Consociated Subjectivity, and Links to Health Activism Expanded Reflexivity as a New Type of Health Activism: Alternative Pathways to Raising Awareness 8.5 Conclusion PART 5: THE STORY IN PRACTICE: ARTISTIC INTEGRITY CONTESTED……..387 CHAPTER 9: Power: Compromise and Institutional Control of Experience……………………………..390 9.1 Innovation in Practice Institutional Control, Integrity, and Compromise Hlalanathi’s Experience 9.2 Bridging the Gap: Putting Ideology into Practice The Changing Relationship between the State and the Arts Tracing Divisive State Influence: Following Money between the Health and Arts Sectors Dominant Models of HIV/AIDS Intervention in South Africa: Past and Present Health Arts Funding Environment Where Does the Money Go? Problems with Donor Funding Patchy Comprehension of Theatre’s Institutional Positioning Over-Reliance on Funding Shifting Role of the Arts in the Post-Apartheid Era: “Our Voices Are Not Being Heard” 9.3 Industry Interactions and Negotiating Competing Interests Knowledge Production and Inequality Resources and Skills Training Industry Bureaucracy Relying on Industry Connections Institutional Control of Experience: The Politics of Health Communication and Compromise Production Content Production Aesthetics Target Audiences 9.4 Conclusion CHAPTER 10: Speaking Back to Power: Creative Economies and Parallel Contributions…………….…465 10.1 Creative Economies 10.2 Parallel Contributions v 10.3 Cultural Capital and Interdisciplinarity: The Importance of Complementarity and Boundary- Crossing Complementary Approaches “By Your Bootstraps”: Ideological Shifts to Complementarity Range of Service Modalities and Moving Beyond Antagonistic Division Recognizing Difference and Connecting Disciplines From Straw-Man to Complementary Approaches Boundary-Crossing 10.4 Challenging Hegemonic Notions of “Progress” and “Success” Moving Toward Different Metrics of Success and Progress 10.5 Conclusion CHAPTER 11: Conclusion to Dissertation …………………………………………………………………...505 11.1 Dissertation Contributions 11.2 Future Lines of Inquiry BIBLIOGRAPHY……………………………………………………………………………..523 APPENDIX A………………………………………………………………………………….556 APPENDIX B…………………………………………………………………………...……..558 vi Acknowledgments I was speaking with a friend the other day about her favorite foods, and she said it’s more of a favorites nebula than a list,
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