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The making-of-vulnerabilities-understanding-the-differentiated[1]


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The making-of-vulnerabilities-understanding-the-differentiated[1]

  1. 1. African Journal of AIDS Research 2007, 6(2): 165–173 Copyright © NISC Pty Ltd Printed in South Africa — All rights reserved AJAR EISSN 1727–9445 The making of vulnerabilities: understanding the differentiated effects of HIV and AIDS among street traders in Warwick Junction, Durban, South Africa May Chazan1* and Alan Whiteside2 1 Department of Geography and Environmental Studies, Carleton University, 1125 Colonel By-Drive, Loeb 349, Ottawa, Ontario K1S 5B6, Canada 2 Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Private Bag X 54001, Durban 4000, South Africa * Corresponding author, e-mail: The end of apartheid in South Africa has led to political-economic transition, the deregulation of cities, and increased population mobility, with growing numbers of people living and working in sub-standard and ‘informal’ urban conditions. These processes have created a fertile terrain for the rapid spread of HIV, especially in the province of KwaZulu-Natal. Few studies have considered how the HIV epidemic’s outcomes are interacting with other societal processes, such as globalisation and urbanisation, or how these processes collectively converge with place-specific conditions to expose, drive and compound vulnerabilities to HIV and AIDS. This paper links an analysis of the political economy of South Africa’s HIV epidemic with findings from an ethnographic case study with street traders in Warwick Junction, the largest trading hub in Durban, KwaZulu-Natal. Keywords: age and gender differentials, case studies, displacement, ethnographic study, marginalised groups, socio- economic effects, socio-economic and political issues, urbanisation, vulnerable groups Introduction South Africa’s 1994 election marked its transition from an Yet, vulnerabilities to HIV and AIDS are not evenly oppressive regime to a democratic state with one of the distributed; those constrained by lack of access to world’s most progressive constitutions. This raised the resources, information, education, opportunities, secure hopes of millions who felt that, with political freedom, wealth livelihoods and political voice are most likely to be and opportunities would be more equitably distributed. The infected by HIV and affected by the AIDS epidemic new government has achieved many successes, including (Fassin, 2003). A growing body of research illustrates the improved access to basic services, increased social epidemic’s uneven and accelerating burden among transfers, judicial transparency and sustained economic households and communities, with the greatest effects growth. Yet, just as these accomplishments are being falling on women living in impoverished conditions realised, the HIV epidemic has become insidiously entren- (Marais, 2005). At the macro level, social scientists have ched in families, workplaces and public spaces. attempted to gauge and project the epidemic’s impacts on The first democratic election took place in an era in which economic sectors and social systems (Barnett & neo-liberal economics were gaining global hegemony. Whiteside, 2002). However, few studies have considered Under pressure to open the previously protected economy how the epidemic’s outcomes are interacting with other to global markets, the new government abandoned their re- macro-level processes, such as globalisation and urbani- distributive economic policies in order to encourage foreign sation, or how these processes collectively converge with investment and free market growth. For many, the expecta- specific local conditions to expose, drive and compound tion was that the new government would deliver a better life vulnerabilities. — education, healthcare, housing and jobs — for all. In this paper, we address this limitation by linking an However, this has not materialised (Naude, 2004). analysis of the political economy of South Africa’s epidemic In the post-apartheid era, macro-economic ‘reform,’ with findings from an ethnographic study with street traders globalisation, and the desegregation of urban centres have in Warwick Junction, Durban. We examine how, in Warwick propelled unemployment, urbanisation, and the growth of Junction, rapid societal transition is interacting with the poor urban communities living and working in precarious effects of HIV and AIDS to augment pre-existing vulnerabili- conditions. The legacy of apartheid and these processes of ties. Our analysis suggests that macro-level processes change are converging with the HIV epidemic. manifest differentially within this context.
  2. 2. 166 Chazan and Whiteside Warwick Junction was selected as the research site in isiZulu; research assistants facilitated three-way conver- because it is a clearly demarcated locale and a nexus of sations between themselves, participants and the primary vulnerabilities. It is the largest trading and transport hub in researcher by guiding and translating the semi-structured Durban (eThekwini Municipality), which is a large South interviews. These interviews were scribed by the primary African port city of just under three million people1 on the researcher (as audio-recording was impossible in the east coast in KwaZulu-Natal Province. A bus station, train market) and research assistants and traders were given the station and several minibus taxi ranks are located in this opportunity to review all interview transcripts. area, which lies just outside the central business district. Developing trusting relationships with participants was Street traders in this area exemplify how particular forces of likewise at the core of the process. In the first phase of the societal transformation have come to bear on this heteroge- research, between September and December 2004, each neous and marginalised group and also how such a group participant was interviewed three times. Interviews were can come to shape the character of a rapidly changing intended to last one hour, although in many cases urban locale. Most street traders came into the city with the researchers would spend up to one half-day at traders’ end of apartheid and as a result of rising unemployment stalls, conducting interviews intermittently while traders and political violence in their home areas. The majority went about their business. This amount of time and contact maintain patterns of circular migration with their homes in was necessary to allow traders to feel comfortable in the surrounding rural areas. Many have been drawn to disclosing sensitive personal information. Warwick Junction as a matter of survival, as it offers liveli- At the end of the first phase, a focus group was held for hood opportunities, however meagre — selling goods and traders. This was facilitated in isiZulu with the purpose of services to thousands of commuters each day. In the relating back the findings and gaining input into the prelimi- context of the unfolding epidemic, Warwick Junction traders nary interpretations. The same group of traders was then appear to be a particularly vulnerable group: located in the visited and interviewed at six-month intervals over the province with the highest HIV prevalence, many face following two years. Traders also received accessible insecure livelihoods and precarious living conditions, and printed materials relating the study findings to date, twice 70% are women. during the course of the study (see Chazan [2005] for a The paper begins by introducing Warwick Junction as a more detailed discussion of this participatory methodology). place of historical significance and a research site illustra- All components of the research were reviewed and received tive of broader social processes. It then examines the politi- ethical clearance through Carleton University. cal economy of vulnerability to South Africa’s HIV epidemic, showing its roots in apartheid structures, rapid change, Warwick Junction: a window into converging societal globalisation and population mobility. It next explores the processes nuances of local-level vulnerabilities, based on the experi- ences of street traders in Warwick Junction. The paper Approximately 8 000 street traders, most of whom are Zulu ends by tracing key linkages between South Africa’s women, sell goods and services to about 450 000 daily interacting macro-level processes and the micro-level commuters in Warwick Junction. Most traders are not effects of the epidemic on street traders. protected by social security and labour legislation, and the majority earn well less than ZAR 1 000 (~US$200) per Methodology: overview of ethnographic research month (Devey, Skinner & Valodia, 2002). Many work long hours in hazardous conditions — cooking on open fires, Research in Warwick Junction was carried out between inhaling exhaust fumes, avoiding harassment from security 2004 and 2006 to examine how the epidemic is affecting workers and customers, and enduring flare-ups of crime street traders, what makes them vulnerable, and why. It and violence — earning barely enough for their families to was instigated, designed and carried out by one of the survive. The survivalist nature of most street-trading, the authors — originally as part of a master’s thesis (from precariousness of traders’ working conditions, their low Carleton University in Canada), and later as part of an education levels, limited negotiating power, lack of access evolving partnership between Carleton University and the to resources and information, and their lack of social Health Economics and HIV/AIDS Research Division protection combine to increase their vulnerabilities to HIV (HEARD) at the University of KwaZulu-Natal, Durban. and AIDS (Lee, 2004). The study involved focus groups and interviews with Traders sell a range of goods, including fresh produce, street traders, healthcare providers, traditional healers, prepared foods, alcohol, second-hand clothing, electronics, municipal officers and trading committee leaders, with 65 cigarettes, household items and crafts. They offer services participants in total. Given the objective of gaining an in- such as hairdressing, shoe repair, tailoring and pay depth understanding of street traders’ vulnerabilities, it also telephones. Others make their living by transporting goods included ethnographic research with a smaller number of for traders and collecting and selling recyclables. Some street traders: repeated interviews and extensive partici- traders have obtained municipal permits and secure trading pant observation with 20 street traders over a two-year sites; others trade without permits, either on the peripheries period: 12 females (six older and six younger) and eight of the area or as itinerants. Warwick Junction is also home males (four older and four younger). to the largest muthi (herbal medicine) market in southern Training and developing relationships with local research Africa; approximately 700 people sell traditional herbal assistants was an integral part of the research process. All remedies there, and some function as traditional healers interviews with traders were carried out in Warwick Junction (Dobson, 2004).
  3. 3. African Journal of AIDS Research 2007, 6(2): 165–173 167 Some traders sleep on the street, some in shelters and being raised about the project’s sustainability and the some in informal settlements. A small number live outside impacts of government withdrawal from management the city centre, in the surrounding townships. Most traders (Grest, 2000). maintain close ties to their rural homes; they travel back Warwick Junction is thus a “terrain of study which is both and forth, send money and goods home, and maintain the very specific outcome of its own historical development, households located in several locations. and also contains elements which are more central to an Warwick Junction is a contested space where different examination of broader social processes” (Grest, 2000, p. forms of poverty, livelihood, displacement, control and 2). While the growth of street trading in South Africa is a democracy are constantly negotiated. From 1900 to the end result of rising unemployment and the mass influx of people of the 1930s, it was a vibrant working-class neighbourhood into the city, it also mirrors a global trend towards informali- and a ‘mixed’ trading area. From the late 1930s until the sation — a trend towards increasingly precarious liveli- end of the 1970s, black Africans were increasingly barred hoods (Lee, 2004). In Warwick Junction and beyond, the from trading in the city. In the 1960s, Durban city bylaws effects of liberalised renewal efforts are uneven, and overall comprehensively outlawed trading, labelling traders as conditions for street traders remain poor (Lund, 2002). The illegal intruders. Laws were passed restricting hawking and majority of traders have few resources or safety nets upon preventing traders from staying in one location for more which to draw when faced with shocks or longer-term than 15 minutes (Nesväg, 2002). The 1970s saw forced stresses, including those associated with HIV and AIDS. removals, the building of a freeway that divided the precinct in two, and the discontinuation of municipal services in the HIV/AIDS vulnerabilities and South Africa’s epidemic area (Grest, 2000). In the 1980s, repression was replaced with deregulation. What is HIV/AIDS vulnerability? With the imminent collapse of apartheid, people previously This paper draws on the concept of ‘human vulnerability’ in denied access to the city began to stake claims. Minibus order to examine the underlying processes driving uneven taxis ‘invaded,’ and Warwick Junction became the site of HIV infection, AIDS impacts and response capacities (see intense trade and taxi activity. Formal traders and residents Kelly & Adger, 2000; O’Brien & Leichenko, 2000). Three organised against informal traders and taxi drivers, and points, described below, are central to understanding how there were several violent stand-offs (Grest, 2000). Crime vulnerability to HIV and AIDS is conceptualised in this paper. and conflict intensified, propelled by political instability and First, vulnerability is the likelihood of being infected or a city council that lacked the legitimacy to regulate trading affected by the epidemic (Barnett & Whiteside, 2002). conditions. The period from 1993 to 1996 was unsettling in Vulnerability encompasses: the chances of becoming Durban’s streets, and with international eyes on the newly infected by HIV, the rate of progression from HIV infection democratised nation and globalised economy, fears of to symptomatic AIDS, and the likelihood of broader impacts repelling investors motivated intervention (Grest, 2004). of the epidemic. In 1996, responsibility for management of the informal Second, vulnerabilities are dynamic and must be economy was decentralised to municipalities, and Durban understood over an extended timeframe. In South Africa, adopted a development-oriented approach (Skinner, 2004). HIV prevalence is already high and morbidity and mortality The municipality identified urban renewal as a priority and are increasing. However, the time lag between HIV infection chose Warwick Junction — one of the most degraded and and societal effects means the full impacts of the epidemic, derelict parts of the city — as its pilot site. The Warwick such as orphaning and family fracture, will only unfold over Junction Urban Renewal Project (WJURP) began in 1996 as decades. The epidemic is creating immediate shocks for a “scrub-up,” including forced removals of informal settle- some people, while the societal impacts of the epidemic ments (Dobson, 2004). The new muthi market was created must be understood as longer-term stressors. From this on an unused overpass, a permit system established, and perspective, vulnerabilities depend on the cumulative and the project administration located in a renovated warehouse linked effects of the epidemic and other societal processes in the area (Grest, 2000). In 2001, the pilot project expanded (e.g. unemployment rates) that mediate individuals’ and to nine other area-based renewal sites. groups’ response options. The renewal project has improved safety, security and Third, vulnerability pre-empts harm from any given cleanliness. Warwick Junction was transformed to the point external shock; however, the presence of an external where it is touted by the municipality as a major success stressor may ‘unveil’ or expose underlying vulnerabilities story and even a tourist attraction.2 But crime, decay and that were previously unrecognised (Vogel & O’Brien, 2004). poverty have not disappeared; nor have the benefits of the Vulnerability is a differential concept, linked with uneven project been shared evenly (Lee, 2004). Rising unemploy- power relations, social inequalities, disempowerment, and ment and urbanisation mean that despite potentially social, economic and political marginalisation (Kalipeni, improved working conditions, many street traders remain 2000). This suggests that uneven vulnerabilities in South highly vulnerable, and there are growing numbers turning to Africa were generated by prior social and economic trading each year. Traders report the market is saturated conditions: vulnerabilities to HIV infection existed before the and competition is growing; they are working harder for epidemic started; and vulnerabilities to AIDS impacts exist smaller returns. Furthermore, the initial pilot project in before the society has experienced the full effects of Warwick Junction has expanded significantly, but because orphaning and other consequences. the municipality has invested only limited human and Identifying what makes certain people and groups vulner- financial resources into this expansion, questions are now able in specific places could assist in developing interven-
  4. 4. 168 Chazan and Whiteside tions to prevent negative outcomes. This requires nuanced hundreds of thousands of people were infected. The and contextualised understanding of how people experi- timing of the epidemic is indeed one of history’s terrible ence intimacy, construct their sexual identities, negotiate backhanders: ‘liberation’ occurred at a moment when this wellbeing, and access livelihoods and security. It also new disease was silently spreading. The numbers have means looking forward at the changing society and unfold- continued to grow and the uneven effects are now ing impacts of the HIV epidemic. emerging. Although disaggregated data are not available, we assume the profile of HIV infection among traders in What do we know about South Africa’s epidemic? Warwick Junction is similar to the rest of the province of Although the first isolated AIDS cases were reported in KwaZulu-Natal. 1983, surveys found a very low HIV prevalence in South Africa prior to 1990 (Karim, 1999). The first national survey, Warwick Junction in a broader context: the shaping of carried out among women attending public antenatal traders’ vulnerabilities to HIV and AIDS clinics3 in 1990 found a prevalence of 0.8%. At the time of the 1994 elections, HIV prevalence was approximately While the HIV epidemic is relatively new in South Africa, 7.6%; by 2005, it had reached 30.2%. There are marked vulnerabilities to infection and impacts are not — they are variations in HIV prevalence by region, race, age and intertwined with the country’s history and its political gender in South Africa. The highest prevalence has consis- economy. In this section, we analyse the political tently been in KwaZulu-Natal Province (national and provin- economy of vulnerability to HIV and AIDS, setting the cial data are shown in Figure 1). epidemic within a broader context of historical, political, Two population-based surveys,4 carried out in 2002 and economic and social relations. We argue that the conver- 2005 by the Human Sciences Research Council (HSRC) and gence of the epidemic with the legacy of apartheid and the Nelson Mandela Foundation, provide HIV prevalence the recent political transition is augmenting pre-existing data by race, age and gender. The 2005 survey shows the vulnerabilities for some populations; we then map out the highest levels of infection are between age 25 and 29 for particular effects, and accelerated nature, of this conver- women (33.3% prevalence) and between age 30 and 39 for gence in Warwick Junction. men (23.3% prevalence) (Shisana, Rehle, Simbayi, Parker, Apartheid had its roots deep in South Africa’s colonial Zuma, Bhana, Connolly, Jooste & Pillay, 2005). Young history. With the election of the National Party in 1948, women are more likely to be infected, and because HIV is a ‘race’ became the dominant organisational principle for lifetime condition, these women carry the burden of infection discrimination. Black people were restricted to impover- forward as they age. Thus, a survey in Hlabisa (in rural ished reserves, kept out of education and jobs, and had no KwaZulu-Natal) in 1992 found 6.9% of women in the 20–24 democratic rights. age group were HIV infected. Ten years later this cohort was Apartheid fragmented households; vast numbers of men aged 30–34 and prevalence for them was 38.4% (Gouws & migrated to work in white-owned factories and mines, Karim, 2005). Not only are women infected younger, but leaving their wives and children in increasingly impover- there are more women infected than men. In 2005, the ished rural communities, dependent on remittances. The Department of Health estimated there were 5.54 million fracture of families had an impact on the construction of people infected: 3.12 million women, 2.19 million men and gender relations generally, and masculinity particularly 235 060 children (Department of Health, 2006). (Campbell, 2003). This created a culture of multiple partner- The HIV epidemic entered South Africa in the late 1980s ing and served to destroy the social fabric of many families and took hold in the early 1990s. By the first election, and communities (Sparks, 2003). 40.7% 40 39.1% 37.5% National 36.2% 36.5% 35 32.5% 32.5% 33.5% KZN PERCENTAGE (%) 30 26.9% 25 19.9% 20 18.2% 15 14.4% 9.6% 10 4.8% 5 2.9% 1.6% 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Figure 1: HIV antenatal seroprevalence in South Africa and KwaZulu-Natal Province (source: Department of Health, 2006)
  5. 5. African Journal of AIDS Research 2007, 6(2): 165–173 169 The ‘transition’ (during the 1980s and early 1990s) was mobility; from 1980 to 2002, the urban percentage of the characterised by opposition, resistance and increasing population increased from 48% to 58% (World Bank, 2005). repression. Political and civil violence throughout many These processes are converging with the HIV epidemic. rural and peri-urban areas resulted in killing and destruc- And their interaction has driven the spread of HIV and is tion, giving rise to waves of refugees fleeing to urban areas. hindering the capacity of some to respond to the epidemic. The violence was consistently worst in the province of Natal Warwick Junction is a place where the dynamics of and the homeland of KwaZulu. This legacy is seen in unemployment, desegregation, urbanisation and HIV and Warwick Junction: many of the older traders were forced AIDS manifest in palpable ways; yet how these processes out of their rural homes in this era. Meanwhile, the eco- differentially generate vulnerabilities, and their complex nomy was under rising pressure as sanctions began to effects on people’s lives, requires closer scrutiny. have an effect and investors withdrew. Yet, on the political front there was movement, with Converging societal processes: Warwick Junction as a meetings between the African National Congress (ANC) nexus and groups of Afrikaners in the 1980s, and the release of political prisoners in 1990. When the country went to the Warwick Junction provides a glimpse into the convergence polls in 1994, the ANC swept to victory nationally. of particular social forces — those of political-economic At that time, the only coherent economic policy was the transition, informalisation, rising unemployment, and urbani- rapidly-developed Reconstruction and Development sation. The interaction of these processes affects street Programme (RDP), which promised to redistribute land and traders’ health and wellbeing and the result is heightened provide for basic needs, including housing, water, electricity, HIV and AIDS vulnerabilities. This section looks at how healthcare and education. The ANC needed to deliver but traders are affected by the epidemic, what makes them faced a weak economy, a declining tax base and no new vulnerable, and why. It shows that within this group, vulner- investment. The RDP quickly fell out of favour and by 1996 abilities are uneven, and it links these with the converging had been replaced by the new Growth, Employment and societal processes detailed above. Redistribution (GEAR) policy. GEAR aimed to achieve eco- nomic growth through attracting foreign investment, increa- Differentiated vulnerabilities among street traders in sed domestic savings and fiscal discipline. Warwick Junction It is not clear to what extent this change in tack was due None of the participants in this study were asked to disclose to local pressures or to dominant international economic their HIV status, but all revealed being personally affected orthodoxies. Commentator Alistair Sparks describes GEAR by the epidemic. Many had lost close family members, cared as for people sick with AIDS, taken in orphans, felt the financial “an unvarnished free-market programme, directly in burden, and watched customers and friends die. Traders’ line with the neo-liberal agenda, or what is known as social and economic circumstances suggest that, as a the ‘Washington consensus’: a combination of relaxed group, they are vulnerable to the HIV epidemic; yet, even exchange rates, privatisation, fiscal discipline and within this group, vulnerabilities are not uniform. Traders’ collaboration with the private sector to produce vulnerabilities are underpinned by social and economic export-driven growth” (Sparks, 2003, p. 193). characteristics that are differentiated by age and gender. For some this was reform, for others a sell-out. Table 1 documents key concerns of the traders by age Regardless, economic stagnation and unemployment were and gender, illustrating the differentiation of their vulnerabili- made worse by the opening up of the economy and the ties at the micro-level. It depicts two clear trends, which are ending of agricultural subsidies. Globalisation may have examined in more detail below. First, younger traders share positive outcomes where the labour force is able to obtain pervasive fears of HIV infection, and these fears are employment and participate in production for export. In shaped by gender relations and gender-specific circum- South Africa, however, apartheid laws excluded the black stances. Second, older traders are vulnerable to the labour force from education and thus many lack the impacts of the epidemic, with older women experiencing necessary skills to compete in the global economy. What disproportionate social, economic and emotional stresses. we saw was a contraction in formal labour, outsourcing, and Collectively, these trends reinforce the findings of AIDS informalisation. There was a massive influx into the urban impact studies conducted elsewhere and with other South areas, resulting in growing numbers living in ‘informal’ and African populations (Marais, 2005). Yet, probing more impoverished conditions. The lack of formal employment deeply into the underlying conditions and processes that led people to seek livelihoods in informal trading. There are drive these impacts, as we do through the remainder of this currently an estimated half-million traders in South Africa, paper, highlights the distinct and uneven ways that macro and about 20 000 in Durban (Charmes, 2003); they are and micro processes converge and manifest among among the most economically marginalised in the country. Warwick Junction traders. Since 1994, three key interacting processes have continued and been amplified. The first is political transformation — Younger traders however imperfect, there is now democracy and accounta- Younger traders fear becoming HIV infected and expressed bility. The second is economic change, globalisation and a shared sense of anxiety and inevitability (see Box 1). the adoption of neoliberal policies; with this, the income gap They raised concerns about how they would access between rich and poor has grown and unemployment has treatment, care and support if they were to fall ill. Most risen (Nicholson, 2001). The third is urbanisation and reported that they would return home to their families, but
  6. 6. 170 Chazan and Whiteside Table 1: Differentiated HIV/AIDS vulnerabilities among street traders in Warwick Junction, Durban, South Africa Men (n = 8) Women (n = 12) Younger Fear of infection; Fear of infection; Stigma; Fear of dying and leaving behind young children; Lack of social support; Difficulties negotiating sexual practices; Lack of access to services; Feelings of powerlessness; Losing customers to HIV/AIDS. Stigma. Older Losing friends and community members; Burden of caring for sick family members; Losing customers to HIV/AIDS; Financial strain of supporting sick family members or orphans; Emotional stress about children; Financial strain of orphans. Lack of communication with younger family members. were worried about the lack of livelihood opportunities and highlights gender dynamics in which men appear to have health services in rural areas. Younger traders worry about more choice than women: in individual negotiations of not having adequate social support, and some felt it would sexual behaviour and in social norms that allow them to be difficult to disclose an HIV-positive status to their families have multiple partners. because of the stigma attached to AIDS. However, these projected attitudes stand in direct Social and economic stresses, gender relations and contrast to young men’s unanimous fears of getting tested broader social norms underlie young traders’ fears, and or becoming ill. Young men were worried about living with these fears reveal key differences between genders. Young stigma and many felt they would not have access to social women were afraid of dying and leaving their children: ‘In support if they fell sick. This widely voiced lack of support the next five years I could die, and who will look after the was expressed starkly by one young man: ‘I don’t know kids?’ (21-year-old maize cooker, female). They worried what I’d do. No one would be able to take care of me. I their families would not be able to support them if they don’t have anywhere to go. I might kill myself’ (34-year-old became sick and that resources would be stretched too male hairdresser). thinly to properly look after their children. All the young Young men in this study reflected an overall sense of women were concerned with the stigma they or their anomie. They reported not having economic opportunities; children would face if they were to present with symptoms. they spoke about partaking in ‘reckless’ or risky behaviours The fears of young women go beyond caring for their because they felt hopeless about the future. In another families, as they often feel powerless to prevent infection. interview, the 34-year-old hairdresser explained it would be While four of the six expressed a belief that condoms are easier for him to deal with the epidemic if he could ‘find a effective, only one was using them consistently, and this nice job and work, because if you have a nice job and work, only in the last six months since the birth of her child. A then you have a future, and you have money to help your young woman cooking curries explained: ‘I feel threatened brothers and sisters, and you could have a wife.’ The lack but I’m not protecting myself…I don’t use condoms. My of employment and support, together, underpin young boyfriend doesn’t want to and he says he doesn’t have men’s vulnerabilities. another girlfriend.’ Another young woman clearly described Although the attitudes, concerns, projected sense of her sense of powerlessness: ‘[My boyfriend and I] talk control, and reported practices were contrasting, fear of HIV about it, but we are from the rural areas where we believe infection played deeply into young traders’ psyches — both in having one man. If our man gets someone on that side men and women. There was a universal sense of anxiety while we are on this side, we have no control over that…I’m and inevitability among young traders, compounded by the scared of it. I talked to my boyfriend about it but now he stigma around HIV and the interaction of high unemploy- doesn’t trust me and doesn’t want me to sell here in the ment levels, lack of social security and displacement from market. He thinks I have someone here. I can’t protect their families. These fears appear to be further shaped by myself from this’ (19-year-old shoe seller, female). social and economic circumstances that are gender-specific. All the women in the study claimed to be monogamous; ‘being faithful’ was their primary defence against HIV Older traders infection. These women rationalised that being faithful to Where the younger traders discussed their own personal their current partner is adequate. However, their partners fears of infection, the older traders were concerned with were unwilling to use condoms, and they suspected these the impacts they were experiencing and would face in the partners were not monogamous. future. Older men reported losing friends, community Younger men projected more control over their sexual members and customers, and they were worried about practices.5 All claimed to use condoms sometimes and to their children. They were feeling the financial strain of ‘turn women away’ who were not willing to do the same. orphans in their home communities. As one man Yet, the interviews showed inconsistencies, as many men explained: ‘It’s affecting me a lot. I know a lot of people shared the attitude that condoms are not necessary in who have passed away because of it and it’s still going to marital relationships and stressed (or boasted) that they be there until the government makes a real plan for have multiple partners. The unevenness in attitude treatment. Most cases are from the rural area…. Orphans
  7. 7. African Journal of AIDS Research 2007, 6(2): 165–173 171 Box 1: Feelings of fear and powerlessness among young traders ‘My parents are very strict and I don’t know if they would accept if a family member had it. They don’t talk about sex’ (21-year-old mealie cooker, female). ‘Sometimes I think about getting tested, but then I get too scared’ (25-year-old barrow boy). ‘I’m worried about HIV. I would love to know. But it’s not curable, so what’s the point [of getting tested]?’ (21-year-old mealie cooker, female). ‘I’m keeping some money to deal with it when it comes’ (21-year-old trolley pusher, male). are a problem because all the families are poor. Kids are listen, people wouldn’t be dying this way, at this rate. They being taken by relatives’ (46-year-old sunglasses and don’t believe it kills, they don’t believe it will happen to accessories trader, male). them, or they don’t think the person they’re with has AIDS. Perhaps most revealing in this study, and certainly least I’m talking about it because it is something that’s happening documented in the AIDS literature, was that, of the four to me. I am talking about my kids. I take them to the clinic; I groups of traders, older women were experiencing dispro- take home condoms. They don’t listen though; they are still portionate effects of the epidemic. The story of an older taking risks…. I suspect my son has it…. How are we seamstress who was taking care of three sick nieces supposed to help if he won’t get tested? (40-year-old mat among her 18 dependents illustrates the distinct and seller, female). profound vulnerabilities of older women: ‘Another niece, a Caring for the extended family and the pressure of being third one, is also having it. She was pregnant before and the primary financial supporter deepen the effects of the the child died and now she’s pregnant again. But she’s epidemic among the older women traders. Exacerbating troublesome. She’s stealing, prostituting. All of this really these consequences was their fear that they could succumb stresses me…. I take care of all of them and I will be the to illnesses that would diminish their capacity to provide one to care for the orphans…’ (52-year-old seamstress of support and care. Indeed, all the older women in this study church uniforms). suffered from (largely untreated) chronic illnesses such as Older women are bearing the brunt of the social, care- diabetes, arthritis and hypertension. In the follow-up taking, economic and emotional burdens of the epidemic in research, half the older women traders could not be located their families. Two-thirds of the older women interviewed and were reported by neighbouring traders to have stopped had taken care of, or were caring for, family members or trading because of illness. neighbours sick with HIV-related illnesses, and in most At the micro-level, therefore, we can see that while the cases, these women had nursed several people in this epidemic manifests unevenly, HIV is compounding the pre- situation. By contrast, only one-third of the younger women, existing vulnerabilities of almost every participant in this one-quarter of the younger men, and none of the older men study. Many traders are feeling an increased burden of had cared for a relative whom they suspected had HIV. care, financial stresses, emotional trauma, and distressing The economic impacts of HIV and AIDS on the already fears for the future. Different traders are vulnerable in differ- stretched incomes of older women are of paramount ent ways, some due to their own HIV infection and some concern; two-thirds said it was having significant financial due to the impacts on their family or community, with trends impacts. These women reported that they were supporting emerging along age and gender axes. growing numbers of people on shrinking incomes, and half were looking after orphans. The older women were worried Convergence: linking societal processes with on-the- about future financial implications: funeral expenses, the ground vulnerabilities cost of taking in orphans, the potential costs of treatment and care (both of HIV and of secondary illnesses), and the While similar analyses of the macro and micro contexts of stresses that would result if they had to take time off work. HIV and AIDS have been undertaken elsewhere (Marais, Furthermore, the emotional toll of the epidemic is consid- 2005), this paper expands upon current theorising by erable: helplessness, fear, worry, and despair overshad- examining the linkages between macro processes and owed conversations about HIV or AIDS among all the micro conditions. Many of the effects on traders docu- traders. In the case of older women, they were extremely mented above indeed mirror findings emerging elsewhere. worried about their children, even if they were not yet sick. However, deeper investigation reveals that underlying Being displaced from their children and trying to care for vulnerabilities are shaped by a particular suite of political- family members in several locations (in rural, urban and economic processes and that Warwick Junction is a nexus peri-urban areas) was a major underlying stress for these for these interactions. women. However, with very few income earners in their How urbanisation and rising unemployment affect traders, families (because of high unemployment and increasing and how these processes interact with the epidemic, are levels of illness) they saw no choice but to remain in the not uniform. We have seen that traders’ experiences are city, trading as much as possible. Difficulties communicating conditioned by the broad societal processes of change and about the epidemic were further compounding their their pre-existing and personal circumstances. Two cases stresses, and the debilitating intergenerational silence was — younger men and older women — further elucidate and affecting both the younger and older traders: ‘If they would reinforce these linkages.
  8. 8. 172 Chazan and Whiteside Young men’s vulnerabilities are shaped by their lack of the political economy of HIV and AIDS and the nuances of livelihood options, which is tied to rising unemployment place-specific vulnerabilities. levels and minimal education and training opportunities. Street traders in Warwick Junction are among the most These circumstances are influenced by exclusion from vulnerable to the HIV epidemic because of their geographical education and employment and by macro-economic ‘reform’ location (in the South African province with the highest and globalisation. At the micro-level, these processes are prevalence), livelihood insecurity, displacement from their generating feelings of hopelessness, with implications for families, and lack of social protection. This may be reflected constructions of masculinity and risk-taking behaviours. in higher levels of HIV infection, although there are no data Young men also reported experiencing inadequate social on this. There is clear evidence of a convergence of factors support and a sense of alienation in the city, which is linked that create a disproportionate likelihood of infection and a to their displacement from home and to increased mobility constrained capacity to respond to impacts. Traders are and urbanisation more broadly. HIV has entered into this disadvantaged by the past, and their insecurities acceler- environment, and the hopelessness, risk-taking and ated by recent political, economic and demographic alienation described by the young male traders in Warwick change. Their vulnerabilities to HIV and AIDS were gene- Junction increases their likelihood of infection; their vulnera- rated prior to the epidemic. It is on top of and linked to the bilities are a result of the converging macro and micro convergence of macro processes that the HIV epidemic has processes that were in motion prior to the epidemic. spread and AIDS impacts are unfolding. Older women are affected by the lack of rural livelihood At the micro-level, vulnerabilities are differentiated, and in options. They are feeling the impacts of rising unemploy- Warwick Junction we see this by age and gender. For the ment in their families, and are increasingly the only income younger traders, it is the fear of HIV infection that causes earners. They are stressed by dislocation from their families the greatest anxiety: for young women, it is fear for their and the difficulties of caring for their children back in the children and the inability to negotiate safer sex that rural areas. They too are negotiating the stresses of rising dominates; for young men, the lack of livelihood options unemployment and urban migration. These stresses are and social support shapes their view of the future and their being made worse by the HIV epidemic, as older women behaviour. Older men feel the impacts as members of their tend to assume responsibility for orphans and sick family communities die; they express a burden of increasing members. Their vulnerabilities have resulted from a responsibility. Yet, this study shows that it is the older combination of these macro processes and their distinct women that bear the greatest responsibility. They care for micro conditions, particularly their disproportionate family the sick and orphaned — often by travelling back and forth responsibilities. This manifests not as an increased likeli- between their rural homes and the city and by continuously hood of infection, but as an increased burden of care. sending back their meagre earnings — and many are the Moreover, it is important to recognise that two levels of primary income earners in their families. differentiation emerge in this study. First, among traders, What is of most concern is that HIV is relatively new, vulnerabilities vary between sub-groups, and especially by and prevalence is still rising. We know that it will be at age and gender. Second, street traders in Warwick least another five years before we see a peak in the levels Junction, as a group, are disproportionately vulnerable to of mortality, and perhaps another 10 before orphan HIV compared to other sectors of the population — numbers reach their highest level. In the meantime, each Warwick Junction is itself a nexus of vulnerabilities. While December sees a new cohort of school-leavers entering urbanisation, globalisation and the transitional political the job market, but with many ending up in the informal economy are creating opportunities for some, for most economy, including on the pavements of Warwick street traders, these processes are generating conditions of Junction. From our study, we note the burden of care is social and economic vulnerability — conditions where they already rising, and women living apart from their families and their families do not have the resources to adequately are bearing the bulk of this burden. The experiences of respond to the HIV epidemic’s complex and long-term traders in Warwick Junction have exposed such uneven effects. Thus, traders are differently vulnerable at different vulnerabilities, providing an important window into the times in their lives and in different contexts, and there are intricate links between these inequalities and the broader marked differences in vulnerabilities between individuals, political economy. groups and sub-groups. Notes Conclusions 1 The 1999 figure for the Durban metropolitan area is 2.69 million Traders in Warwick Junction are negotiating their wellbeing people, but this does not account for rapid in-migration or the at the epicentre of rising unemployment, urbanisation, and impacts of HIV/AIDS (Metropolitan Durban, 2005). 2 Durban has won international acclaim for the project, although one of the largest HIV epidemics in the world. They are trading in one of the largest informal markets in South Africa few tourists visit the area (Grest, 2004). 3 Samples taken from pregnant women are used in these surveys. – a predominantly Zulu trading hub (as opposed to markets The samples are unlinked and anonymous. The samples comprised mostly of migrants from other African countries). exclude women accessing private healthcare. They have come through apartheid and their options have 4 This population-based survey took a random sample from South been shaped by it as well as the transformation of South African households. Africa, Durban and Warwick Junction. Their experiences 5 Sexuality consists of complex emotions, relationships and thus provide a glimpse into the intricate linkages between actions, which are linked to constructions of masculinity,
  9. 9. African Journal of AIDS Research 2007, 6(2): 165–173 173 femininity and gender relations. Deep fears around the epidemic Gouws, E. & Karim, Q. (2005) HIV infection in South Africa: an are common to both men and women, but their attitudes, evolving epidemic. In: Karim, S. & Karim, Q. (eds.) HIV/AIDS in concerns, projected sense of control and reported practices are South Africa. New York, Cambridge University Press. contrasting. Grest, J. (2000) Urban citizenship and legitimate governance: the case of the Greater Warwick Avenue and Grey Street Urban Acknowledgements — We would like to thank all those in Warwick Renewal Project, Durban. Paper presented at the South African Junction who participated in the research, shared their stories, and Planning History Study Group Millennium Conference on made this study possible. We are extremely grateful to S’bo Planning for Reconstruction and Transformation, Durban, South Radebe, Ntombi Thula, Sihle Sithole and Phumzile Cele for their Africa, 29–30 May 2000. insights and assistance with the fieldwork. We acknowledge the Grest, J. (2004) Pers. comm., Department of Political Science, generous support received from the International Development University of KwaZulu-Natal, Durban, 6 October 2004. Research Centre of Canada for the fieldwork. We would also like to Kalipeni, E. (2000) Health and disease in southern Africa: a thank Mike Brklacich, Tim Quinlan, Jeremy Grest and Caroline comparative and vulnerability perspective. Social Science & Skinner for their input into the work. This article is offered in Medicine 50, pp. 965–983. memory of Sihle Sithole. Karim, S.S. (1999) Making AIDS a notifiable disease — Is it an appropriate policy for South Africa? South African Medical The authors — May Chazan is a research associate with the Journal 89, pp. 609–611. Health Economics and HIV/AIDS Research Division (HEARD) at Kelly, M. & Adger, N. (2000) Theory and practice in assessing the University of KwaZulu-Natal, and she is a doctoral candidate at vulnerability to climate change and facilitating adaptation. Carleton University, Ottawa, Canada. With a background in geogra- Climatic Change 47, pp. 325–352. phy, health sciences, education and political economy, May has Lee, S. (2004) Assessing the Vulnerability of Women Street carried out ethnographic research with street traders in Durban for Traders to HIV/AIDS: A Comparative Analysis of Uganda and the past three years, focusing in particular on how grandmothers in South Africa. Health Economics and HIV/AIDS Research South Africa are affected by HIV and AIDS. Her most recent work Division (HEARD), University of KwaZulu-Natal Durban, South involves critically examining social mobilisation around HIV/AIDS in Africa. South African communities. Lund, F. (2002) Social security and the changing labour market: Alan Whiteside is Director of the Health Economics and access for non-standard and informal workers in South Africa. HIV/AIDS Research Division (HEARD) at the University of Social Dynamics 28(2), pp. 177–206. KwaZulu-Natal, where he is also a professor. Alan holds a DEcon Marais, H. (2005) Buckling: The Impact of AIDS in South Africa. from the University of Natal, and is a development economist by Pretoria, Centre for the Studies of AIDS, University of Pretoria. training, working in the field of HIV/AIDS for the past 20 years. His Metropolitan Durban (2005) Population Indicators: Metropolitan major research interest is exploring the causes and consequences Durban. Durban Metropolitan Council, South Africa. of the HIV epidemic. Naude, W. (2004) Post-apartheid South Africa in the world economy: an assessment of inequality in an open developing References country. Africa Insight 34(4), pp. 46–53. Nesväg, S. 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