More than numbers

Two UTSC researchers examine social impacts of HIV/AIDS in Africa

Lanna Crucefix

By Lanna Crucefix

In the second year of his doctoral studies, Mark Hunter was doing preliminary research on labour issues in South Africa. He loved the country, where he’d spent time volunteering as a teenager and later working on his master’s degree. “Then I began to wonder why I was studying labour when I was going to funerals every weekend,” he says. “I was totally overwhelmed with how many people were dying of AIDS.”

Hunter began to reconsider his research focus.


Bianca Dahl pondered the news story she’d just read about two orphanages in Ethiopia. The first was filled with HIV-negative children. Eligible for overseas adoption, they were learning English and being taught about American culture. The second housed HIV-positive children who lacked access to treatment and were deemed unadoptable. In the interests of fairness, the aid organization funding both orphanages had decreed that the second group of children would spend their short lives learning the same skills—skills that, for them, were useless.

How many other well-intentioned aid organizations are making these kinds of decisions? she wondered. And how does it affect the children?


Hunter and Dahl are two UTSC faculty members examining the impact of the AIDS epidemic in southern Africa through the experiences of the people most affected.

In the past 30 years, AIDS has killed more than 25 million people worldwide. Another 34 million live with the disease. In sub-Saharan Africa, the hardest-hit region, nearly one in every 20 adults lives with HIV.It is the world’s leading infectious killer.


Against this cruel backdrop, the gentle emotions that tether close relationships can get lost in the stark statistics of the infected, the dying and the dead. Public health reports focus on risk factors and transmission rates. Love, affection and intimacy are more difficult to quantify.

For Hunter, now an associate professor in the Department of Human Geography, these overlooked emotions play an essential role in understanding the HIV/AIDS epidemic in South Africa.

Conducting research mostly in Zulu, Hunter would listen to his neighbours chat from his small concrete-block “jondolo” in Mandeni, the “AIDS capital of South Africa.”

“People would say, why is this person infected with HIV? Well, because she has three boyfriends. She needs one to pay her rent, one to pay for food and one to buy clothes.”

Hunter realized he was observing the intersection of several societal, historical and economic trends that were, in effect, driving the epidemic in South Africa.

Due in part to the lasting effects of racial discrimination, South Africa has experienced a very large rise in unemployment a radical decrease in marriage rates and a significant increase in the migration of rural women.

Hunter explains the connections in his award-winning book, Love in the Time of AIDS: Inequality, Gender, and Rights in South Africa. Thirty years ago, a rural woman tended to remain in her village and marry a local man who then supported her.
Fast forward to the 1990s. Rural women left their villages to find work, which paid less than they needed to survive.

High unemployment meant that men were unable to meet ‘the bride wealth,’ the marriage payment to a woman’s family. Lowered marriage rates resulted in sex outside marriage, with a larger turnover of sexual partners due to the high migration rates.

Instead of marriage, it is now common for a woman to have a “central” lover and one or more “secondary” lovers. Each provides her with gifts and support, such as helping pay for accommodation, food or children’s needs.

Hunter calls it the “materiality of everyday sex” and says sexuality can’t be divorced from issues of political economy. However, he stresses that despite the exchange of goods and money, these are not prostitute/client relationships.

“The partners consider themselves boyfriend and girlfriend. They may be long-term romantic relationships with emotional attachments. There may be children.”

Yet, the very structure of these intimate relationships is feeding the AIDS epidemic, he says, as those who are part of them often do not wear condoms.

Hunter’s arguments run contrary to the majority of previous research, which tends to present black South Africans as indulging in loveless transactional-sex relationships despite infection risk. It is important to understand the logic of these relationships, Hunter says, which result from the pressures of inequality and unemployment.

“You can never—in any country—separate love from the material world. That’s only in a Hollywood movie.” 


The news story about the two orphanages led Dahl, an assistant professor in the Department of Anthropology, to Botswana. There, she studied how children orphaned by AIDS were raised, and how they were affected by the international aid flowing in to support them.

Working primarily in a village she calls Lentswê, Dahl examined the impact of orphan care centres such as the Bathusi Orphan Day Care. Its pioneering program provided resources and allowed orphans to continue living with relatives. Eventually replicated across southern Africa, the foreign-run program gained international renown for its work to provide culturally sensitive support.

However, Dahl’s findings were disheartening. “Many practices foreigners imported in the name of respecting culture ironically, and usually inadvertently, negatively affected orphans and their families,” she says. For instance, clothes and gifts from aid institutions, more lavish than could be afforded by relatives, often caused envy and weakened children’s ties with their extended families.

One telling example of the gap between Western and Tswana cultural norms concerns Bathusi’s music therapy program. Aid workers taught children to perform sad songs with what they considered to be appropriately grieving faces.

“This defied local Tswana ideas about emotion, which emphasize letting go of negative emotions and finding ways to express and feel joy beyond sorrow,” says Dahl, who speaks Setswana. The orphaned children shocked their fellow villagers with their culturally inappropriate feelings.

Dahl’s work is part of a larger movement within Botswana's government to implement safeguards, licensing requirements and official oversight of foreign aid organizations. Working closely with social workers and government officials, she has been involved in at least two cases that closed programs which were ultimately doing more harm than good to children.

“I hope my work will cause some well-intentioned aid organizations to rethink their approaches toward supporting children and other populations in other countries,” she says.


From relationships to orphans’ care, the research undertaken by Hunter and Dahl tell another side of the AIDS story, one that emphasizes the people behind the numbers and delves into questions of why, as well as how.

For Hunter, it’s also about bearing witness. “I wanted to write the history of this devastating epidemic and why I think it happened. Even if there is a cure for AIDS, we should never forget that millions have died across the continent.”