'Seeing for yourself'

Abstract

Attempts to analyse the impacts of HIV/AIDS on individuals and households have tended to consider HIV/AIDS as a distinct and primarily medical issue, unrelated to other processes and vulnerabilities. Drawing upon a holistic livelihoods and entitlements approach, this mixedmethods research demonstrates that the impacts of HIV/AIDS must be understood within the context of multiple, dynamic, and co-existing vulnerabilities and institutional processes which influence the capability of different individuals and households to both access and mobilise key livelihood assets. The importance of recognising local perceptions and understandings of HIV/AIDS is also stressed. Despite HIV prevalence of 43 percent, few people in Caprivi Region are aware of their HIV status and continuing stigma and misunderstandings prevent those who are from disclosure. Under such circumstances, alternative illness narratives exist, providing `acceptable' explanations for illness and death which adversely influence key decisions regarding treatment and `coping' responses

Recent socio-cultural change, increased economic heterogeneity and an upsurge in witchcraft accusations within Caprivi Region are straining traditional familial support structures and safety nets, resulting in household welfare particularly provision of care for ill people, becoming an internal responsibility. Solicited diaries kept by ill people and their main carer provide an innovative insight into the physical and psychological pressures of long-term care. The necessity to continue with livelihood activities to maintain food security results in carer fatigue and stigma against the ill person, particularly if HIV/AIDS is suspected. The increasing dependency of the ill person not only influences their ability to seek treatment, but also their ability to undertake expected familial and livelihood roles. This research found that an inability to `see for yourself'. i. e. be self-sufficient, or contribute to reciprocal support networks results in stigma, isolation and rejection both within and beyond the household. This research argues that inequalities and stigma are hampering effective HIV/AIDS prevention and impact mitigation in the Caprivi Region