Children as Victims

The Moral Economy of Childhood in the Times of AIDS

Dialogue

João Biehl

João Biehl

You said that children are at the intersection of a global moral order and local public health. How might we situate this moral economy within the discourses of security and humanitarianism that frame global health? Also, how are children being theorized in economic and development terms today? There has been emphasis on early interventions in the health of children as a way to guarantee better economic outcomes in the long run. Journalist Laurie Garrett has made the case that too much funding has gone to address HIV/AIDS and that global health funding should prioritize child and maternal health because that’s how allegedly you will get more comprehensive health systems and development. This is a population-level argument with a different temporality than that of treatment access. And in this case, the child is the crucial nexus.

Ian Whitmarsh

Ian Whitmarsh

Is there more of a structural dynamic that might inhere in the logic of innocence? Innocence is a discourse of purity. Is there a moral certainty that gets created? The pure innocent will entail the impure, sexualized mother that you talk about. Does this set up a kind of moral purity/certainty of which the speaker/crusader takes part? The worst thing then becomes the betrayal of that innocence. I wonder then if in this vision there is a necessary removal or invisibility of children that might be considered “complicit” like, for example, drug users?

Julie Livingston

Julie Livingston

The historical trajectory from childhood to adulthood is very important here. There are these double-figures: mother/deviant sex worker, grandmother taking care of orphans/but resistant to Western medicine. Each figure must be cleaved from its shadow image in order to be deployed. Also, we’ve talked about what numbers mean, obscure, reveal. But voices are no less troubling. Both quantitative and qualitative data require this kind of interrogation. A final note, the politics of the state seem to be untouchable somehow. When Thabo Mbeki was the scapegoat in South Africa, it was easier, but the real story is more complex. The idea is that because we cannot do anything about the state we must operate outside of it. A mid-level analytics of state politics, as some people mainly working in comparative frameworks have been calling for, is necessary.

Didier Fassin

Didier Fassin

The semantics of global health—security, bioterrorism, epidemics on the one side and humanitarianism, solidarity, compassion on the other—works as a dialectic rather than a contradiction: in other words, they are intimately linked. Experts writing reports for international organizations often strategically present security and solidarity as two faces of the same problem, arguing for instance that we need to help Africa with Aids and poverty for the benefits of the Western world. As far as how children are theorized in economics, I can say two things. First, the argument about “investing” in children is not new. There have long been discussions about the relative value of investing in a younger versus an older person (for example in 70s and 80s development theories). But behind this economic argument, there is still a moral one (analyzed by historians for the West but also valid in Africa). It is about how we see children as innocent and vulnerable to be spared and protected. Second, the argument relating children to mothers is ambiguous, since the justification for saving women is that children will be saved. In the case of the prevention of mother-to-child transmission of HIV, this logic went so far as to ignore the risk of drug resistance for women. Also, in this discussion, a question remains: where are the men? They are absent from the debate, except for the fact that they are often called irresponsible fathers and sexual abusers. The mortality of men should also be a concern. Finally, on the question of purity and victimhood, children are, of course, not just victims, and they can also be violent with each other. But that violence needs to be erased from discourse in order for the image of innocence to hold, at least up to the point where the logic is reversed and they start to be seen as dangerous again.

Vincanne Adams

Vincanne Adams

What does this misrepresentation of childhood authorize? What is gained? How are moral conundrums displaced? How did we get here, to this focus on children, given that twenty five years ago, primary healthcare interventions were organized around maternal and child health? Children were not being seen then as the same kind of victim. There was a different kind of emphasis.

Michael A. Whyte

Michael A. Whyte

These images of innocence are drawn largely from newspapers, but what about other sources? Also, there are many things outside the family that shape the child, notably schools. How to account for different constructions of childhood, outside of the family?

Joseph J. Amon

Joseph J. Amon

In terms of the AIDS epidemic, early on, a lot of the rhetoric from an epidemiological standpoint was that children were less important because they did not transmit the disease from person to person. The shift in terms of their importance in South Africa also seems related to the idea of treatment as a right for everyone. Moreover, the notion of abstinence only probably contributed to creating innocence among children. Not that children are necessarily innocent, but that they need to be made innocent. Your figures on sexual abuse are on the low side of what is going around. Might this also create innocence in a reciprocal way?

Feierman

One move here that is similar to a move in Vincanne’s paper is on the issue of de-contextualization and de-socialization. History is telling here. During the apartheid years, infant mortality rates for the homelands were not being collected and recorded. This raises basic questions of citizenship. Children were not citizens. Another question is the “black peril” journalistic portrayal of African men raping white women. The threat of sexual violence removes mothers from their children. Violence and innocence raise questions about where the threat is and who is capable of acting on children’s behalf. If you see these questions as a matter of public policy, then those capable of acting for the vulnerable are those who make policy, rather than anyone else in the social setting. I am reminded of a study done by a demographer on the question of investments by HIV positive parents in the education of their children. The assumption was that, given rational calculations of the future, parents knowing that they would die soon would invest less in the education of their children because they wouldn’t expect children to have to support them. But the study showed the exact opposite. The more likely parents were to die of AIDS, the more likely it was that they would support the education of their children. The presumption was that these parents wouldn’t act in a value-informed way.

Clara Han

Under Pinochet, there was a paucity of epidemiological data, but infant mortality was counted as a measure of development. I want to reemphasize that there seems to be a difference between the erasure of the mother and the sheer survival of the child. The mother is necessary for child survival. Any female head of household (even the oldest sister) in Chile will get monetary subsidies from the state before the father.

Didier Fassin

Didier Fassin

In previous works, about trauma in particular, I have tried to differentiate the construction of victimhood in the public sphere from the perceptions of people who are the supposed “victims” (but who often do not consider themselves as such). Actually many resist this designation and want to be seen as actors. But my paper is not an ethnography of childhood. It is an analysis of the moral economy of childhood, which I connect with its political economy. As for the category of “AIDS orphans,” it comes from international organizations trying to put names on the cause they defend. By doing so, they seem to imply that the problem of orphanhood started with AIDS. This has to do with the supposed exceptionality of AIDS that makes many Africans uncomfortable: What about other health issues? What about the other orphans? Another issue is that the emotional reification of childhood eludes historical perspective. It also eludes social critique. By focusing on individualized cases, structural factors are downplayed. This is very clear in the images of AIDS orphans in which there is never any attention paid to the political economy of orphanhood. These images, in effect, obscure the massive situation of violence in southern Africa where twice as many children are orphans from fathers than from mothers due to homicide, suicide, or generalized violence, and not AIDS (as it is claimed by most organizations). Moreover, the representation of AIDS orphans ignores the fact that in South African families’ children are not seen only as victims but as financial resources.

What I have tried to do in my paper is to discuss what seems taken for granted. In French “évidence” means obviousness, as opposed to “evidence” as proof in English. As anthropologists, we confront false évidence with our empirical evidence. This theoretical critique which we are conducting is certainly relevant to policy-makers, as it goes against the grain of commonsense.