Reconsidering the orphan problem: The emergence of male caregivers in Lesotho

Care for AIDS orphans in southern Africa is frequently characterized as a crisis , where kin-based networks of care are thought to be on the edge of collapse. Yet these care networks, though strained by AIDS, are still the primary mechanisms for orphan care, in large part because of the essential role grandmothers play in responding to the needs of orphans. Ongoing demographic shifts as a result of HIV/AIDS and an increasingly feminized labor market continue to disrupt and alter networks of care for orphans and vulnerable children. This paper examines the emergence of a small but growing number of male caregivers who are responding to the needs of the extended family. While these men are still few in number, the strength of gendered ideologies of female care means that this group of men is socially, if not statistically significant. Men continue to be considered caregivers of last resort, but their care will close a small but growing gap that threatens to undermine kin-based networks of care in Lesotho and across the region. The adaptation of gender roles reinforces the strength and resilience of kinship networks even when working against deeply entrenched ideas about gendered division of domestic labor

Exposed Intimacies: Clinicians on the Frontlines of the COVID-19 Pandemic

COVID-19 has overwhelmed health-care providers. The virus is novel in its prevalence, severity and the risk of asymptomatic infection. In order to reduce the risk of infection and stop the spread of COVID-19, clinicians in hospitals across the United States are taking measures to limit exposure to infected patients by reducing the frequency of visits to patients’ rooms, touching patients less, and adopting new protocols around the use of personal protective equipment (PPE). While these newly adopted practices are helping to reduce transmission risk of COVID-19, they are producing a habitus of infection; an acute shift among clinicians that is deeply embodied and likely to have a permanent impact on the health and wellbeing of both providers and already isolated patients

Living, dying, after death: Achieving a good death in the time of AIDs orphan care

AIDS has devastated communities across southern Africa, leaving many children orphaned. Grandmothers are considered ideal caregivers because of cultural expectations of intergenerational care, and because they have not been decimated by AIDS to the same extent as younger adults. However, these grandmothers, who currently carry the majority of the burden of care for AIDS orphans, are themselves aging and dying. I argue here that in Lesotho, the caregiving demanded of grandmothers late into their lives not only alters kin relations for the living, but has increasingly made a “good death” unachievable for elderly caregivers

Flexible kinship: Caring for AIDS orphans in rural Lesotho

HIV/AIDS has devastated families in rural Lesotho, leaving many children orphaned. Families have adapted to the increase in the number of orphans and HIV-positive children in ways that provide children with the best possible care. Though local ideas about kinship and care are firmly rooted in patrilineal social organization, in practice, maternal caregivers, often grandmothers, are increasingly caring for orphaned children. Negotiations between affinal kin capitalize on flexible kinship practices in order to legitimate new patterns of care, which have shifted towards a model that often favours matrilocal practices of care in the context of idealized patrilineality

Review of Making Refuge: Somali Bantu Refugees and Lewiston, Maine by Catherine Besteman

Catherine Besteman conduced fieldwork in the late 1980’s in the small village of Banta in southern Somalia. Implausibly, she was reunited with many of her former friends and interlocutors in Lewiston, Maine two decades later, laying the ground for this impressive ethnographic study. In Making Refuge, Besteman traces the experiences of Somali Bantu refugees from Somalia, through the Kenyan refugee camps, and to their resettlement in the United States. She shows how the prevailing view of refugees as “apolitical, docile, and dependent recipients” (Pg. 29), and as passive and grateful objects of humanitarian aid is both misconstrued and morally deficient. By tracing the particular journey of Somali Bantu families, she also underscores that not all immigrants are alike, and assimilation is not a universally desirable or feasible expectation. Finally, she shows the complex ways in which immigrants and host communities grapple with “the seepages, mutual transformations, and slow border crossings of all kinds,” (Pg. 31) which characterize human mobility. While a transcontinental coincidence of migration brought Besteman back into close contact with her former interlocutors in this methodologically innovative work, it is Besteman’s skill as an ethnographer that provides the emotional and intellectual rigor for this outstanding book

The AIDS House: Orphan care and the changing household in Lesotho

HIV/AIDS has brought the connections between care and relatedness into sharp relief. In the midst of social change driven largely by the AIDS epidemic, the house has emerged as the most stable element connecting kin in Lesotho. Houses provide spaces that frame human actions, transform relationships, and reflect the social order. The house is a key crossroads for human movement. It is also the site where physical connections, emotional bonds, and feelings of love and affection are nurtured. Most significantly, it is the site where physical acts of caring take place. Based on extensive ethnographic research, I demonstrate that the house is one of the places where the pressures of AIDS-driven change are most felt because of its role in structuring care. AIDS has intensified the importance of the house as caregiving has become a primary means for shaping relatedness

Kinship

Kinship is a term used broadly in the social sciences, particularly in anthropology, to mean the web of social relationships that make up families. It is a useful framework for thinking about changes over the life span because people’s roles within their families and social networks change as they age and as the social, political, and economic contexts in which they live shift. There are three main concepts that help to explain the importance of kinship across the life span: Kinship is created through practice, kinship is processual, and kinship is inherently flexible. This entry provides a brief history of kinship studies, explores each of these three concepts, explains how they are relevant to understanding the life-span perspective, and provides illustrative examples

Paternity matters: Premarital childbearing and belonging in Nyanga East and Mokhotlong

In this article we discuss the role that fathers and paternal families play in acknowledging and caring for children born outside of a recognised union in two southern African communities – Nyanga East, South Africa and Mokhotlong, Lesotho. While these communities are geographically and culturally close, there are important differences in the responses to the care of children born outside of a recognised union. In Nyanga East, despite not paying damages, the genitor and the paternal family are increasingly becoming involved in the care of children, even when they are no longer in a relationship with the mother; whereas in Mokhotlong, if a pregnant woman is not in a formal or informal union with the father, she and her family effectively erase the genitor’s role in the child’s life. We argue that these local variances in the kinship dynamics arise from people privileging different kinship relationships. We suggest that in both contexts kinship is manipulated in order to find a place where a child will be well cared for, enable educational opportunities for young mothers, and privilege employment opportunities for adults who bring much-needed income into households. The article reinforces the importance of contextually specific understandings of kin relations and a fluid and processual understanding of kinship itself

Risk Perception in Cardiovascular Disease

Cardiovascular disease (CVD) remains among the leading causes of death in the United States despite widespread knowledge about risk factors as well as effective primary prevention strategies. Risk perception is a complex phenomenon that plays an important role in how persons view disease and ultimately how they make health behavior choices. This study is supported by the knowledge that few studies have examined how persons perceive cardiovascular risk or the variables thought to contribute to the formation of risk perception. Purpose: The purpose of this study was to examine how accurately persons perceive personal risk for cardiovascular disease and identify variables that contribute to the formation of risk perception. Methods: This study used a cross-sectional descriptive correlational design with adults at least forty years old and without known cardiovascular disease. The nonprobability convenience sample was recruited at health screenings held at multiple locations within a single hospital system in Northwest Indiana. One hundred thirteen participants who could read, write, and speak English completed the study booklet containing a compendium of questions regarding knowledge and awareness of CVD from the American Heart Association, as well as established tools to measure the key variables: the Cardiovascular Risk Individual Perception instrument (CRIP) measuring risk perception, the Revised Life Orientation Test (LOT-r) measuring optimism, the Life Engagement Test (LET) measuring life satisfaction, and the Patient Health Questionnaire (PHQ-8) measuring depression. Participants also consented to share physiological measurements and laboratory results from the community screening program. Actual cardiovascular risk was calculated using two tools: the Heart Health Scale (HHS; Wellsource screening tool) that provides information on current risk , and the Framingham Risk Score (FRS) that projects one\u27s 10-year risk for a cardiac event. The study was approved by the institutional review boards from Loyola University Chicago, the hospital where the screenings were held and the university where the investigator is on faculty. Results: Study participants had a mean age of 58 years, 69% were female, 70% were White Caucasian (non-Hispanic), and the majority were married, well-educated, employed, and had private insurance. Overall the sample recognized heart disease as the leading cause of death for men and women and could identify the key prevention steps to reduce personal risk. While physiological measurements obtained during the screenings revealed a relatively healthy group, with the majority of participants at goal for glucose, LDL-C, HDL-C and triglyceride levels, the majority were also found to be either overweight or obese, and physically inactive. Overall, 80% had two or more self-reported risk factors, and 43% had three or more. Participants did accurately perceive their personal risk, with the prevalence/number of self-reported risk factors being significantly correlated with higher levels of risk perception as measured by the CRIP (r=.44, p \u3c .01). HHS scores showed that more than 55% of the participants were categorized as either Needs Improving or High Risk , indicating the presence of multiple risk factors. HHS scores were also statistically correlated with risk perception (r=-.40, p \u3c .01). In addition, chi square analysis showed a significant relationship between increased risk (using HHS) and increased risk perception scores (using CRIP). Framingham Risk Scores, a measure of projected future cardiac risk, were not correlated with current risk perception. The majority of the sample had increased levels of optimism and life satisfaction and low levels of depression. While three variables (having a friend with CVD, optimism, and depression) were correlated with risk perception, depression was found to be the single predictor when entered into multiple regression analysis (B = .278, p = .003). Implications for Providers: Community based health screenings play an important role in primary prevention strategies. Although persons may accurately recognize that they have risk factors for CVD, this alone may not be enough to prompt positive health behavior changes. Persons often need further counseling to understand the role risk factors play in subsequent subclinical atherosclerosis. While mass media campaigns related to healthy eating, exercise, and heart disease have increased health literacy in this area, health care providers need to be part of this dialogue since they are uniquely positioned to counsel patients on effective methods for promoting positive health behaviors

Three, Two, One, Action: Incorporating Video Projects in Class Pedagogy

Ethnography is useful as a pedagogical tool because it uncovers layers of meaning, relies on inductive reasoning, and allows students to generate theory grounded in the empirical world. Likewise, using video project assignments encourages deep engagement, increases student recall of new knowledge, and links visual clues to memory. Video projects also encourage creativity and teach transferable technological skills. In this panel, I explore the pedagogical praxis of combining ethnographic methods, such as participant observation and interviewing, with video-making projects to encourage durable learning. Student co-presenters will show clips from their video projects and reflect on the impact of the assignment