<最終講義>自己統治の技法 : 北タイのエイズ自助グループ
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概要
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The AIDS pandemic that has arisen since late 1980s in Thailand, has led to greater surveillance and control through the promotion of preventive medicine. On the other hand, a great number of people living with HIV/AIDS have been unable to receive effective and affordable treatments of their illness, and have often been confronted with severe social handicaps and discrimination. The necessity for more autonomous self-governance of their own health under the domination of costly modern medicine and health care, opens up a contesting space around ways of coping with the pandemic. It is in this context that since the early 1990s in Northern Thailand, HIV/AIDS self-help groups have emerged to seek ways for their own survival and societal acceptance. This paper examines the activities of this new type of community or association, in which the people with HIV infection acquire knowledge and organise practices for survival given the prevailing social discrimination, and the overwhelming influence of the established medical power of the state and its discourse. The self-help groups, composed mainly of coming-out members, urge other infected people to participate in their activities; especially by providing counselling and conducting negotiations with medical institutions, administrative authorities and other forces. The activity of these groups is perhaps best defined by what J. Lave and E. Wenger call the 'community of practice', a matrix of learning and organising social practices through participation. The self-help groups develop an open-ended identity through negotiations for survival with the practitioners of external sources of knowledge, rather than constructing a strong sense of belonging to the community as is often emphasised in other instances of the community of practice. This particular feature of identity formation, which enables the members to cope with their ever-changing uncertain and contingent circumstances, results in a multiplicity of subject positioning, as would be expected if viewed in the context of Nietzschean and Foucauldian trajectories. However, the emergence of such a negotiable, therefore non-identical, subject is only possible at the contested space at the interface between, on the one hand, the attempts to constitute their own subject in an active fashion, and, on the other, the dominating discourses and practices of the medical institutions of the ever-growing nation-state. In this contested space, the people living with HIV/AIDS develop self-governance involving alternative styles of practices by means of continuous assessments of whatever medical information and expertise they have access to.
- 1999-12-27
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