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‘Deadly gonorrhoea’: history, collective memory and early HIV epidemiology in East Central Africa

The local historical imagination has associated the appearance of AIDS in two ways. Science Bennett FJ.

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After the rebellion in eastern Zaire cut the eastern that when the network finally dispersed there were enough parts of the country off from Kinshasa and the Atlantic in infected individuals to successfully introduce the virus to the mids, new trade routes for products to and from another, much denser and geographically wider sexual the eastern provinces were established through Central and network.

The interviews consist of group and key sion, thus directing collective remembering within the group. These informants were chosen on the basis Prostitutes Nsunga their occupy an important position in the Prostitutes Nsunga memory and age, history of residence, and experience with the AIDS identity of the Prostitutes Nsunga, while this may not be the case epidemic since the early s.

In terms Prostitutes Nsunga written sources, at all. Thus, a researcher must tread carefully while making the article uses a selection of Ugandan and Tanzanian judgments about the significance or historical correctness of newspapers English and vernacularofficial documents the things remembered, discussed or forgotten. The article attempts to Prostitutes Nsunga together a because of the sensitivity and intimacy of the subject.

Yet the collec- and other Prostitutes Nsunga from outside the local realm of experi- tive memory is consistent with epidemiological histories of ence, thus producing a historical representation which various STDs in the region; the high prevalence of syphilis is logical, yet not conclusively true or false see Munslow and gonorrhoea until the s and their reduction through Thus, the power of lay testimonies, in this case, lies tant, inconvenient, embarrassing or painful.

The fallacies in their capacity to illuminate the historical context in which of individual memory and remembering can, to a degree, one particular STD epidemic is said to have taken place, be avoided by investigating the collective memory of a and in describing its perceived pathogenic progression. Much of the evidence is circumstan- memories frequently refer. Generally, oral traditions and Prostitutes Nsunga, which contributes to the reconstruction of the historical histories preserved in collective memory are organic and context of the epidemic, but gives no reference to any malleable.

They Prostitutes Nsunga be reorganised or re-imagined to fit the diagnoses or prevalence rates. Enquiries concerning past requirements of changing circumstances Halbwachs Accordingly, evidence to back or refute the arguments historically, correct.

Once oral Prostitutes Nsunga and histories presented here may not arise until the local government Prostitutes Nsunga recorded and written down as ethnographies or local Prostitutes Nsunga keeping procedures are brought up to Prostitutes Nsunga.

There histories, however, they become less liable to change, is, however, a growing body of Prostitutes Nsunga on the origin of HIV losing some Prostitutes Nsunga their power as local moral or Prostitutes Nsunga justifi- epidemics in different parts of Africa, which, together with cations and explanations of the present. At the same time, previous academic literature on STDs, will help connect the however, the power of text historicises the written represen- dots in a way that, hopefully, does not leave too much Prostitutes Nsunga the tations of the past and introduces them as subjects to historical imagination.

Once written down, oral traditions and histories become statements about the past, whose signifi- Historical origins Prostitutes Nsunga HIV and AIDS epidemics in Africa cance for historical enquiry is in part determined by their consistency and coherence with other historical sources Whereas the origin of HIV-1 is known today, the origins of Chase and ShawCattell and ClimoTosh with the first HIV-1 epidemics in Africa remain obscure Gao et LangPoole Discussion about the factors Here, the collective memory Prostitutes Nsunga the community has Prostitutes Nsunga contributing to the rise of the HIV pandemic has been going recorded in semi-structured, open-ended group interviews, on since the s, and the hypotheses presented have, during which the participants may discuss and even for example, emphasised the role of accelerated popula- argue with each other about the past.

A well-conducted, tion growth, urbanisation, social change, changes in sexual thematically organised group interview may not yield as culture and large public health campaigns Prostitutes Nsunga Africa since detailed and personal information as an in-depth single the s QuinnHooperMarx et al. In the group et al. Apparently, Prostitutes Nsunga remark refers to female that for HIV-1 to reach epidemic proportions via sexual prostitutes as transmitters of the disease.

To what extent these changes actually took place prostitutes in Kenya, Tanzania, Rwanda and now Uganda, has yet to be established in order to understand the spread and which progressed rapidly and was fatal if left untreated.

People who heard slow expansion, halt and even withdrawal Prostitutes Nsunga a period of him remembered that he talked about a sexually transmitted rapid expansion which gave rise to AIDS epidemics across disease which would cause hair loss, wasting and eventu- Africa and eventually the rest of the globe Amat Roze et. It is quite possible that the aired announce- al. It is also possible that locals have challenge the theories about the timing and onset of the associated weight loss and wasting with the symptoms first HIV-epidemics.

If HIV reached epidemic propor- described by Amin when they later saw people whose illness tions in areas of what is now Republic Prostitutes Nsunga the Congo and seemed to match the condition Amin had talked about.

Since Worobey et al. When the AIDS he had spoken about them on several occasions, urging epidemic broke out in Africa in the early s, the worst people to get treatment and to avoid being infected.

The outbreak of an AIDS Prostitutes Nsunga civil servants and officials for failing to get treatment and at virtually the same time, in the early s, within a belt spreading STDs out of Prostitutes Nsunga fear of being stigmatised and stretching from Matadi and Kinshasa in Prostitutes Nsunga west to Butare shamed.

The other group responsible for the increasing and Bukoba in the east, and the greater severity of the prevalence of STDs was Ugandan girls who worked as epidemic in Central Africa indicate that in the late s prostitutes in places Prostitutes Nsunga Mombasa where they, according and early s the epicentre of HIV and AIDS was in Prostitutes Nsunga Amin, acquired new diseases from Prostitutes Nsunga and then the Kagera triangle, Prostitutes Nsunga is in countries which lie on the brought them to Uganda Anon.

Central and East Africa in the decades preceding the s What Amin witnessed in Prostitutes Nsunga in the s was a speaks to the need to understand the social, economic global trend which began after the Second World War.

It and epidemiological processes involved i. In 12 MayAmin warned Ugandans about a dangerous, the wake of political independence in the s, societies fatal sexually transmitted disease which had broken out in Africa were drawn into this trend of rapid transforma- in Eastern Africa, particularly in Kenya, Tanzania and tion characterised by increased freedom, development Rwanda.

Amin advised influence. He also urged the doctors and health transmitter groups for STDs. Prostitutes Nsunga the s and s, workers not to discriminate against people suffering from civil servants, businessmen, truck drivers, peace keepers, the disease, but to treat them Prostitutes Nsunga and learn more about Prostitutes Nsunga aid workers, development advisers, airline workers and condition. Regarding the epidemiology of the disease, Amin tourists added to the group of highly mobile transmitters, said that the disease was brought to Uganda Prostitutes Nsunga Kenya, whose sexual appetite was satisfied by the ever-growing Tanzania and Rwanda.

Transactional sex, where socially and developing AIDS, which means that they also have more economically deprived women use part-time or temporary time to spread the infection to others Collinson-Streng et prostitution to support themselves and their children, al. As poverty pushed many Individual cases with shorter incubation periods and more women into the sex market, the price of sex declined, quicker than average progression to AIDS — determined enabling even poorer and younger men to purchase by age, health status and the HIV-subtype responsible for it Southall Prostitutes Nsunga GutkindDayWhitethe infection — would have appeared throughout the late SchoepfVandepitte et al.

Unlike called magendo, Prostitutes Nsunga in subsequent years grew mainly other magendo markets in other border areas, the ones on because of massive coffee smuggling by high-ranking the Uganda-Tanzania border seem to have been particu- officials within the Amin administration.

The mids larly unfortunate to have HIV introduced there fairly early, coffee boom greatly expanded the levels of smuggling, perhaps before the mids, and possibly by only a few which now included small-scale, local operators in border infected individuals. In some places, like the southern parts of Rakai The coming of deadly gonorrhoea district, coffee smuggling became a way of obtaining money to buy basic necessities from black Prostitutes Nsunga dealers, who When discussing the s with locals in north-western gathered in a few well-hidden magendo markets near Lake Tanzania, an issue frequently mentioned Prostitutes Nsunga kahuzi.

In the Victoria on the Uganda-Tanzania border. In women, kahuzi may occasionally have local narratives about the origin of the AIDS epidemic caused a similar discharge, but, according Prostitutes Nsunga the locals, it unanimously claim that the disease came from the border Prostitutes Nsunga less symptomatic in women than in men.

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Despite the markets between Uganda and Prostitutes Nsunga cf. Barnett and frequent absence Prostitutes Nsunga visible symptoms in women, however, Blaikie It was brought by men and women actively women were believed to be carriers of the disease. The involved in illegal trade. The exact timing of the first the most common STD in Africa.

By gonorrhoea AIDS Prostitutes Nsunga is, of course, uncertain, but the fact that both was widespread in East and Central Africa, and its high in Uganda and Tanzania the first cases are said to have prevalence was recorded among urban female prostitutes appeared at roughly the same time lends some credibility WHOMeheus et al.

The claim regarding the onset of the AIDS In local reminiscences kahuzi is most commonly associ- epidemic around is based on stories about the first ated with the construction of the Kyaka Bridge FoG with AIDS victims in the villages, most Prostitutes Nsunga which place the first men, 25 MarchIbwera; 21 MarchIzigo.

Kyaka cases between and Lwegabainterview is a small town on the southern bank of the Kagera River, with medical doctor, 24 MarchNdolage. In Africa, the average Burundi to Uganda. The main road from Kampala and incubation period from infection to the first Prostitutes Nsunga of Masaka to Bukoba runs Prostitutes Nsunga Kyaka, and continues on AIDS is approximately the same as that found on other to Tabora and Mwanza; it was frequently used by coffee continents, roughly 7 to 10 years.

However, remark- traders and smugglers in the Prostitutes Nsunga and s Tanzania ably shorter survival times were recorded early on in the National Archives — Before the completion of the epidemic in Uganda. The construction of the bridge HIV-positive adults dying within a year of infection Killewo began in and only 10 years later it was destroyed in et al. This may be because the the Tanzanian-Ugandan conflict and not properly rebuilt HIV-1 Group M subtype D, which was driving the epidemic until the early Prostitutes Nsunga.

The workers were housed in a camp on the southern farmer, 20 FebruaryKasambya; FoG with women, 26 bank of the river, along the Kyaka-Karagwe road, a short FebruaryNshamba; FoG with men, 25 Marchdistance west of Kyaka. Having a large number of male Karonge.

Many women Prostitutes Nsunga to sell beer and sex to workers local reminiscences, suggests that HIV-1 entered north- on site, while others waited for them in Bukoba, the only western Tanzania no later than the early s and began big town nearby, where some of the workers Prostitutes Nsunga to relax spreading among prostitutes and their customers.

Infections on weekends. Women arrived in Kyaka not only from of gonorrhoea and other STDs would have helped the the immediate vicinity, Prostitutes Nsunga also from Uganda and even transmission of HIV-1 during the first phase of the epidemic, Rwanda. Bukoba may even have attracted high-class expansion among Prostitutes Nsunga core groups Carael et al.

This probably took place among the foreigners temporarily or permanently residing in at a relatively slow pace in the early s. Besides construc- tion workers, other groups of people associated with the Routes of HIV-1 into north-western Tanzania introduction of kahuzi included Tanzanian prostitutes working in Kenya and later in Kyaka, Ugandans working The possible entry routes for HIV into north-eastern or doing business in the border area, and Congolese Tanzania and Kyaka are many.

The lake, close proximity Prostitutes Nsunga working at the bridge construction site. Whatever west and east across the lake from Prostitutes Nsunga. It seems HIV-1 the original source of kahuzi, the timing and location of its reached East Central Africa fairly early, in the s, and onset in north-western Tanzania appears fairly constant, Prostitutes Nsunga at a low level of infection for decades Gray et from Prostitutes Nsunga in Kyaka.

By the mids the condition al. Occasional and women selling sex to them. The collective memory AIDS cases were infrequent and geographically dispersed states that kahuzi started at the construction site, Prostitutes Nsunga that enough to indicate any sort of epidemic De Kockit had not been around before.

Gonorrhoea was certainly Low-BeerVangroenweghede Sousa et al. In Rwanda the same subtypes as in north- Kyaka was only one localised hotspot for the transmission western Tanzania dominated the early epidemic, while in of STDs in Tanzania — there were many other projects of Burundi subtype C was predominant and was probably similar magnitude or larger in different parts in East and introduced to Tanzania in the early s.

It seems that subtype D entered Uganda via Tanzania, testimonies, the pathogenesis of kahuzi appears to have for it dominates the southern-most part of Rakai district, but changed it from curable to terminal. While some inform- is replaced by A as the dominant subtype in the northern ants maintained that kahuzi like gonorrhoea was Prostitutes Nsunga part of the district and beyond.

Subtype A is believed to with antibiotics, others remember it as a condition that have entered East Africa in the s from Zaire then the killed its Prostitutes Nsunga after some time. The Population movement in the region offers some clues informants claim that when Juliana came from Kanyigo about the possible routes of HIV. Mitumba and Tanzania between and In the Kagera region other fabrics were either bartered for coffee, bought with of Tanzania they were first settled in camps, and Prostitutes Nsunga money Prostitutes Nsunga through selling coffee to black market re-settled among the local population.

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From todealers, exchanged for sex or bought with money obtained there was a temporary Rwandese refugee settlement in from selling sex Anon ; FoG with women, 19 March Nsunga, some kilometres north of Kyaka, and later nearKanyigo; FoG with men, 19 MarchBukwali; Katoro, south of Kyaka FoG with men, 24 FebruaryFoG with men, 26 MarchKamachumu. It appears Nsunga. Rwandan refugees were Prostitutes Nsunga settled near the that smugglers frequently took sexual advantage of local town of Bukoba.

According to Hooperthis refugee women Prostitutes Nsunga desiring to get mitumba or other products. Inthousands of refugees from Burundi constituted a group Prostitutes Nsunga men who could afford to regularly entered Tanzania, some of whom might have reached the buy sexual services from prostitutes frequenting towns and Kagera region. In the village of Nyankere, a few kilometres border markets.

HIV may have been transmitted Prostitutes Nsunga this south-east of Kyaka, there were adult foreign nationals Prostitutes Nsunga of people, formed around smuggling routes and residing inmost of them from Rwanda and Burundi; centres, to north-western Tanzania and the Kyaka area as they had mainly arrived between and Whereas early as the s.

There were also the levels of HIV in the s must have been extremely Downloaded by [Jan Kuhanen] at 30 April Ugandan men and women, including a few families mostly low in their countries of origin, and the possibility of from Ankole, residing in Nyankere. In the Kanyigo ward anyone being infected in their home country would have close to the Ugandan border, Kigarama and other villages been minimal. A few cases would have most likely turned had dozens of Rwandese and Burundians inmany out be epidemiological dead-ends, since those infected of whom had been around for decades Bukoba District would have had no or very few opportunities to infect Archives If HIV-1 entered Prostitutes Nsunga Kyaka area Prostitutes Nsunga, unless Prostitutes Nsunga belonged to the core groups of prosti- with the immigrants and refugees from Rwanda, Burundi tutes and their regular customers, Prostitutes Nsunga which case there is a and Uganda, it likely did so before because, after chance that in a place like the Kyaka Bridge construction the Prostitutes Nsunga of anti-Amin forces Prostitutes Nsunga subsequent border site, just one infected individual would have been able to skirmishes, the steady flow of migrants to the area, notwith- introduce HIV to a sexual network dense enough to allow standing refugees from Uganda in Octoberseems for higher rates of transmission.

The outbreak of kahuzi to have stopped completely until — when the would indicate that the density of the sexual network around Tanzanian military presence at the border area was relaxed. In was through a regional smuggling network, which is closely conditions like those prevailing in Kyaka aroundHIV associated with the coming of AIDS in local collective infection would linger on in a small population of prostitutes memory Barnett and BlaikieKaijageMutembei who would manage to infect enough of their customers so After the rebellion Prostitutes Nsunga eastern Zaire cut the eastern that when the network finally dispersed there were enough parts of the country off from Kinshasa and the Atlantic in infected individuals to successfully introduce the virus to the mids, new trade Prostitutes Nsunga for products to and Prostitutes Nsunga another, much denser and geographically wider sexual the eastern provinces were established through Central and network.

Eastern Africa. By the early s most of eastern Zaire was supplied from the east by black market traders. By that The rapid expansion of the HIV-1 epidemic c. In Kinshasa, Brazzaville, Bangui and Prostitutes Nsunga opportun- Since Prostitutes Nsunga s the main articles traded by petty local istic infections later related to AIDS started to increase and regional smugglers between Rwanda, Tanzania and after Virologists agree Rwanda was Prostitutes Nsunga primary source of mitumba for north- In most of Central and East Africa, HIV first reached western Tanzania, with a smuggling network stretching epidemic proportions among urban female prostitutes from Prostitutes Nsunga and Rusumu in Rwanda to Kyaka and and their customers, as it did in West-Central Africa, but Prostitutes Nsunga in Tanzania, mainly via Karagwe or Muleba.

He also urged the doctors and health transmitter groups for STDs.

In the eastern-most corner of the Kagera Prostitutes Nsunga forms an the s Zairian and Kenyan fabrics and mitumba began exception to this. The lure unprotected sex with multiple partners on a regular basis, of quick magendo profits was hard to Prostitutes Nsunga in poverty- and, presumably, many of them were already suffering from stricken communities where smuggling offered a means various other STDs.

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When HIV entered this sexual network of improving material wellbeing see Prostitutes Nsungaat the border it found greater core groups than at Kyaka. Kuhanen a, Kuhanen b.

The coffee magendo led They were formed around professional and semi-profes- to increased activity in the sex trade in rural villages and sional prostitutes and their regular and irregular customers, small towns along the principal smuggling routes.

At the who were mobile and who not only enjoyed their money and border market places Prostitutes Nsunga flourished; it was mainly life at the magendo markets, but also in towns and villages, practised by women Prostitutes Nsunga nearby communities, but it also where their wealth and success in business was much attracted women from Bukoba, Kyotera, Masaka and even celebrated.

The men and women acquiring Prostitutes Nsunga infection Kampala.

In Ssanje, a trading village Prostitutes Nsunga southern Uganda at the border markets would Prostitutes Nsunga infect their wives, along the Masaka-Kyaka-Bukoba highway, Prostitutes Nsunga husbands, boyfriends and girlfriends in the villages and is said to have increased substantially after On the Ugandan border with Kenya, similar, local collective memory in north-western Tanzania provides but bigger, markets developed. There, coffee was sold to considerable support to claims of the Prostitutes Nsunga of an STD Kenyan operators, who shuttled between Nairobi and the epidemic in the s.

The paper has also argued that the border, enjoying the services of prostitutes on both sides expansion of the HIV-1 epidemic in north-western Tanzania AsiimweAnon.

The paper Ugandans, Tanzanians, Rwandese, all would suggests that this simultaneous surge of HIV-1 may have meet there. In that market, people were behaving resulted from the expansion of the black market economy like animals; some Prostitutes Nsunga stealing, others would be and smuggling which, by the early s, had replaced the having sex during the day, others having sex during official economy as the only functioning market Prostitutes Nsunga in the night.

HIV probably entered the border area via they were targeting traders. It was a hub Prostitutes Nsunga all Kyaka Prostitutes Nsunga Bukoba, two hotspots of the sex trade and STD the commodities from Uganda and Tanzania and transmission in north-western Tanzania in the late s Rwanda… … Bars used to be grass thatched but and early s. Thus, whether the collapse of the official people used to drink the whole night.

Rwanda and Tanzania in the early and mids helped Rural sexual networks in Central Africa can be dense HIV to reach a phase of rapid expansion is a question to be enough to allow high rates of STD transmission and local considered. In the collective memory of southern Uganda Prostitutes Nsunga epidemics, but they generally lack links with other and north-western Tanzania coffee smuggling, the sex sexual networks outside the community Pickering et al.

On the Tanzanian-Ugandan border in the mids, this Notes pattern was broken. Chase M, Prostitutes Nsunga C. The dimensions of nostalgia. The term is colonial French Equatorial Africa? Retroviruses 5—8. Coker R, Wood PB. Geographic HIV type 1 subtype actual dates from any printed sources. This research was supported by Nsanze H. Prostitutes are a major Prostitutes Nsunga of Prostitutes Nsunga the Academy of Finland. Sexually Transmitted. Diseases 64— Day S. Prostitute women and AIDS: anthropology.

AIDS 2: References — De Kock Prostitutes Nsunga. B — de regionalisation. The Prostitutes Nsunga epidemiology of et de ses Filiales — AIDS — AIDS gives rise to helpless orphans. Enhanced heterosexual transmission hypothesis for the origin of Anon. President awadde ekiragiro ku bakazi. Viruses 4: — High Anon. Amin ayogedde ku ndwadde empya, GUD incidence in the early 20th century created a particularly Standard Digital News. Coffee boom millionaires.

PLosOne 7: e, doi Uganda journal.

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Mamdani M. Since Worobey et al.