IIAS | IIAS Newsletter Online | No.17 | Institutes


Practices and Representations of Health and Illness in the Context of Chinese

Culture. Illness Prevention and Social and Cultural Aspects of the AIDS Issue

In Dr Micollier's project, the lines of study are related to AIDS education and prevention, health-care policies, social change, migrants or foreigners as illness vectors, strategies and discourses of health workers (professional, traditional, and local), patients and families, and practices and perception of the body-self. These last have an impact on practices and representations of sexuality in the context of the HIV/AIDS epidemic remarkable for its social, cultural, and psychological implications as well as for its economic, and demographic aspects.

By Evelyne Micollier

The research project is related to three main topics - the AIDS issue, illness prevention, and aspects of religious and social change in contemporary Chinese societies (PR China, Taiwan) linked to health practices.

The individual project is integrated into a teamwork project: the AIDS issue in an intercultural and multidisciplinary perspective is a priority line of study of the CNRS (Thematic programme on HIV/AIDS, French National Centre for Scientific Research, Social Sciences Dept). The aim is to study the human and social dimensions of AIDS in P.R.C. and Taiwan. In 1997 fieldwork was conducted in PR China (Beijing, Kunming, and Yunnan province) and in Taiwan (Taipei) for a period of six months.
Among the thirty million people estimated to be infected with HIV/AIDS in the world, five to seven million live in Asia. Among the eight and a half thousand new infections per day, two to three thousand are related to the Chinese world. The people concerned are ethnic Chinese (from PR China, Taiwan, Hong Kong, Singapore, and diasporas huaqiao) or non-ethnic Chinese citizens (ethnic groups living in PR China or Taiwan).
In 1998, China has entered a phase of 'fast growth' of HIV/AIDS cases according to the Ministry of Health. Although the number of HIV-positive patients at the end of last year was estimated at four hundred thousand by UNAIDS-China, only 9,970 HIV/AIDS cases had actually been reported nationwide by March 31, 1998. Since the beginning of 1990s, Yunnan province, with a population of forty million has been the epidemic epicentre: this southwest province bordering Burma, the world's foremost producer of opium, is severely affected by drug abuse and trafficking. Before 1997, seventy per cent of the people officially identified as having HIV had been detected in Yunnan. Now, the rate is reduced to fifty per cent as the epidemic spread from the border to inland and coastal southern provinces and northwest Xinjiang following drug trafficking routes and, more recently, children and women trafficking routes.
Showing the same patterns as in Thailand, Vietnam, and Burma, HIV first spread in South China through drug injections then through heterosexual contact. The commercial sex trade is booming along two routes: one running in the direction of the coastal regions (Guangxi, Hainan, Guangdong, Fujian), which are developing economically at a great rate and Hongkong; the other reaches Thailand from Yunnan through Burma. The commercial sex trade and trafficking women are becoming very urgent and alarming human and social issues, which need to be addressed. Migration (a mass-movement putting about ten per cent of Chinese population on the move) as a risk factor for the spread of HIV/AIDS has long been underestimated, a fact that has hindered prevention of the incidence of AIDS and affected the efficacy of the control programme.
Dr Micollier will explain the implications of anthropological understanding in the context of the HIV/AIDS. Anthropological analysis as a form of knowledge bridging gaps between cultures can help in the process of networking and collaborating between local organizations and their foreign counterparts; adjustment of global projects to the local cultural context cannot be undertaken without taking into account qualitative data collected using anthropological methodology. Popular, traditional, and modern (linked to the introduction of Western medicine) practices and representations of health and illness have to be investigated before launching development projects dealing with public health, particularly with sensitive issues like the HIV/AIDS epidemic. This means understanding the components and working methods of medical pluralism.
The fieldwork focuses on various groups in the population: HIV positive/AIDS patients and their families; professional health workers (medical institution); traditional and popular healers involved in STDs and eventually AIDS healing; social organizations (official, non-official, religious) involved in social work and welfare on the HIV/AIDS issue (care and prevention); the general population.
The methodology is one frequently used in the social sciences: quantitative data (epidemiological figures and trends) will be used; qualitative data will be collected by participant observation (in-depth interviews, in-depth ethnographic description), the biographical method (life-stories of main informants); and bibliographical references dealing with the subject of research.
A second line of study about illness prevention is in progress. Preventive patterns (traditional, local, and modern epidemiological-like) intersect with each other and largely overlap health belief models. Preventive beliefs and behaviours will be analysed to understand the underlying logic of these patterns in the context of Chinese culture.
The third topic is about 'New religions' Xinxing zongjiao in Taiwan, religious and social change in contemporary Chinese societies (PR China, Taiwan), realignments in religion : practices in 'New religions' are linked to health practices; these religious activities give a perspective on the cultural identity in Taiwan.
Work in progress is related to the impact of migration, to sexuality, and social change (increase of commercial sex as well as increase in casual sex with peer partners), to vulnerability of local ethnic groups. The case of Chinese Yunnan province and comparative perspectives in Mainland Southeast Asia allow for a focus on South China and Southeast Asia links in the context of the HIV/AIDS epidemic. Representations of the AIDS 'medical situation' are highlighted through images and discourses. In Taiwan, recent trends in health policies to do with health and social issues such as the HIV/AIDS epidemic, drug abuse, alcoholism among Austronesian people, etc. are approached, providing an original way to shed light on social change.
Dr Evelyne Micollier is an ESF-IIAS/NIAS Alliance Research Fellow stationed at the IIAS Branch Office in Amsterdam. For more information on Dr Micollier's, check her web page on the web-site http://www.iias.nl/iias/research/micollier/.

   IIAS | IIAS Newsletter Online | No.17 | Institutes